PET imaging with [18F]3'-deoxy-3'-fluorothymidine for prediction of response to neoadjuvant treatment in patients with rectal cancer

Positron emission tomography (PET) using 18F-labelled 3'-deoxy-3'-fluorothymidine (FLT) was assessed for therapy monitoring in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. Ten patients with locally advanced rectal cancer were included and underwent long-course preo...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2007-06, Vol.34 (6), p.878-883
Main Authors: Wieder, Hinrich A, Geinitz, Hans, Rosenberg, Robert, Lordick, Florian, Becker, Karen, Stahl, Alexander, Rummeny, Ernst, Siewert, Jörg R, Schwaiger, Markus, Stollfuss, Jens
Format: Article
Language:English
Subjects:
5-Fluorouracil
Adult
Aged
Cancer
Cell Proliferation
Chemoradiotherapy
Chemotherapy
Clinical outcomes
Colorectal cancer
Dideoxynucleosides - pharmacology
Emission analysis
Female
Fluorine isotopes
Fluorodeoxyglucose F18 - pharmacology
Humans
Male
Middle Aged
Neoadjuvant Therapy - methods
Nuclear medicine
Patients
Positron emission
Positron emission tomography
Positron-Emission Tomography - instrumentation
Positron-Emission Tomography - methods
Prognosis
Radiation therapy
Radioisotopes
Radiopharmaceuticals - pharmacology
Rectal Neoplasms - diagnosis
Rectal Neoplasms - diagnostic imaging
Rectal Neoplasms - therapy
Rectum
Therapy
Tomography
Treatment Outcome
Tumors
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Summary:Positron emission tomography (PET) using 18F-labelled 3'-deoxy-3'-fluorothymidine (FLT) was assessed for therapy monitoring in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. Ten patients with locally advanced rectal cancer were included and underwent long-course preoperative chemoradiotherapy (total dose 45 Gy, 1.8 Gy/day, concomitant 250 mg/m2 5-fluorouracil) followed by surgery. FLT-PET was performed prior to chemoradiotherapy, 2 weeks after initiation of chemoradiotherapy and preoperatively (3-4 weeks post chemoradiotherapy). FLT uptake was correlated with histopathological tumour regression and changes in T stage. Mean tumour FLT uptake was 4.2+/-1.0 SUV before therapy and decreased significantly to 2.9+/-0.6 SUV 14 days after initiation of chemoradiotherapy (-28.6%+/-10.7%, p=0.005). The preoperative scan showed a further decrease to 1.9+/-0.4 SUV (-54.7%+/-7.6%, p=0.005). However, the degree of change in FLT uptake 2 weeks after initiation and after completion of neoadjuvant therapy did not correlate with histopathological tumour regression. FLT-PET did not seem to be a promising method for assessment of tumour response in the studied chemoradiotherapy regimen in patients with rectal cancer.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-006-0292-2