Comparison of FLT-PET and FDG-PET for Visualization of Head and Neck Squamous Cell Cancers

Hoshikawa, Hiroshi; Nishiyama, Yoshihiro; Kishino, Takehito; Yamamoto, Yuka; Haba, Reiji; Mori, Nozomu

doi:10.1007/s11307-010-0331-z

Cited by 36 publications

(20 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with HNSCC had better PFS and OS in this study, consistent with historic data [3,4,7]. In contrast to the current study, larger prior studies in patients with HNSCC and EC have correlated worse outcomes with higher baseline SUVmax [14,[23][24][25]. Similarly, larger prior studies suggest that higher TLG values correlated with worse oncologic outcomes [24][25][26][27].…”

Section: Discussionsupporting

confidence: 85%

“…Positron emission tomography (PET) with 2-deoxy-2-18F-fluoro-dglucose (FDG) and 3'-deoxy-3'-18F-fluorothymidine (FLT) tracers have been used in HNSCC to define extent of disease and assess response to treatment [10][11][12][13][14][15]. A series of EC patients scanned with FDG-PET before and after induction chemotherapy showed a doubling in two-year disease-free survival when the SUVmax declined by greater than 60% [16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

RS¹,

Vj²,

Rl³

et al. 2017

J Nucl Med Radiat Ther

View full text Add to dashboard Cite

Objective: We prospectively compared FDG-PET and FLT-PET in assessing patient responses to induction cetuximab and/or chemoradiotherapy (CRT) for advanced head and neck squamous cell carcinoma (HNSCC) and esophageal cancer (EC). Methods:Sixteen patients were enrolled, 9 with HNSCC and 7 with EC. FDG-PET and FLT-PET scans were performed at baseline and two weeks into chemoradiotherapy (CRT) for patients with EC. Patients with HNSCC received two weeks of induction chemotherapy along with post-induction PET scans prior to starting CRT in addition to the baseline and intra-chemoradiotherapy PET scans. Changes in SUVmax and total lesion glycolysis/ proliferation (TLG/TLP) were compared with baseline.Results: Median follow-up for living patients was 6.0 years. Median overall survival (OS) was 3.3 years and progression-free survival (PFS) was 2.5 years. Patients with HNSCC had higher baseline SUVmax, TLG and TLP than those with EC. Changes in SUVmax, TLG and TLP after induction chemotherapy or during CRT did not correlate with PFS or OS. Those with >40% decline in SUVmax on FDG-PET six weeks after completing CRT had better PFS (p<0.0001) and OS (p=0.0003) than those with less of a response. In addition, >70% decrease in posttreatment TLG correlated with better PFS (p=0.03) and OS (p=0.04). Conclusions:Functional imaging performed early during chemoradiotherapy for advanced HNSCC and EC is feasible. Changes on post-induction and intra-CRT FLT and FDG PET did not correlate with PFS or OS. However, better PFS and OS were seen in patients with >40% decline in SUVmax and >70% decrease in TLG on FDG-PET performed six weeks after completing CRT. Further research is needed to determine the prognostic impact of PET performed during chemotherapy and radiotherapy.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

RS¹,

Vj²,

Rl³

et al. 2017

J Nucl Med Radiat Ther

View full text Add to dashboard Cite

show abstract

“…All primary tumors were identified but with a large range in tracer uptake; there emerged only a weak correlation between 18 F-FLT uptake and iododeoxyuridine staining intensity in oral cavity tumors. Hoshikawa et al [78] evaluated 43 patients with HNSCCs. The mean SUV for 18 F-FLT was significantly lower than that for 18 F-FDG and significantly higher in poorly than in well-differentiated tumors.…”

Section: Head and Neckmentioning

confidence: 99%

The role of F-18-fluorothymidine PET in oncology

Bertagna

Biasiotto

Giubbini

2013

Clin Transl Imaging

View full text Add to dashboard Cite

3 0 -deoxy-3 0 -([ 18 F]Fluoro)-fluorothymidine, ( 18 F-FLT) is a fluorinated tracer which has been proposed as an imaging biomarker of cell proliferation. The aim of this review is to provide an overall evaluation and description of the diagnostic role of 18 F-FLT PET or PET/CT in oncology imaging and clinical practice. A comprehensive computer literature search of the PubMed/Medline databases revealed 371 articles. After reviewing the titles and abstracts, 285 articles were excluded, mainly because the reported data were not within the field of interest; 86 articles were selected. The overall assessment of the published studies showed marked heterogeneity both of the tumors analyzed and of the reasons for evaluation (diagnosis, staging, restaging, and therapy response evaluation). The tumor or organ most frequently analyzed was the lung, in 19 studies; the digestive tract was analyzed in 17 papers, brain tumors in 15, head and neck tumors in nine, myeloproliferative/lymphoproliferative diseases in nine, and breast cancer in six. Eleven studies dealt with the other forms of tumor (including melanomas, sarcomas, ovarian cancer, uterine cancer, germ cell tumors, and neuroendocrine tumors). Although no high-quality evidence could be derived on the role of 18 F-FLT PET in oncology imaging, because of the extreme heterogeneity between the studies (with regard to the tumors evaluated, the reasons for performing the evaluations, and the devices and methodologies used), the limited number of studies per tumor type, and the very low number of patients enrolled in each study, these preliminary results seem to indicate a promising role for this tracer in oncology imaging, especially in therapy response evaluation and in brain tumors; it is also associated with a lower rate of false-positive results due to inflammation. Further studies are needed to confirm these preliminary results, and larger trials are desirable to establish the definitive diagnostic role of 18 F-FLT in oncological clinical practice, considering its usefulness in relation to and in comparison with the already well-established 2-([ 18 F]Fluoro)-2-deoxy-D-glucose, ( 18 F-FDG), its importance in terms of cost-effectiveness, and its correct position in the diagnostic flow-chart for each tumor type.

show abstract

“…The intracellular trapping of 18 F-FLT is a function of the enzymatic activity of thymidine kinase 1, a key enzyme in DNA synthesis with high activity during the proliferative S phase of the cell cycle and low activity in the quiescent G0/G1 phase (9). Untreated head and neck squamous cell cancers are readily detectable with 18 F-FLT PET, with high tumor-to-background ratios, although the SUV with 18 F-FLT tends to be generally lower than with 18 F-FDG (10)(11)(12)(13)(14). Comparison studies of 18 F-FLT and 18 F-FDG by Hoshikawa et al showed similar detectability and false-positive rates in primary tumors and cervical nodal metastases for 18 F-FLT and 18 F-FDG (11,12).…”

mentioning

confidence: 99%

“…Untreated head and neck squamous cell cancers are readily detectable with 18 F-FLT PET, with high tumor-to-background ratios, although the SUV with 18 F-FLT tends to be generally lower than with 18 F-FDG (10)(11)(12)(13)(14). Comparison studies of 18 F-FLT and 18 F-FDG by Hoshikawa et al showed similar detectability and false-positive rates in primary tumors and cervical nodal metastases for 18 F-FLT and 18 F-FDG (11,12). The pretherapy staging of head and neck cancer with 18 F-FLT PET appears limited by the nontumoral uptake in reactive cervical nodes due to proliferation of reactive B-lymphocytes (15).…”

mentioning

confidence: 99%

PET Imaging During Radiotherapy of Head and Neck Cancer

Menda

Buatti

2013

J Nucl Med

View full text Add to dashboard Cite

Comparison of FLT-PET and FDG-PET for Visualization of Head and Neck Squamous Cell Cancers

Abstract: FLT-PET showed as high a sensitivity as FDG-PET for the detection of primary HNSCC lesions, although uptake of FLT was significantly lower than that of FDG.

Cited by 36 publications

References 17 publications

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

The role of F-18-fluorothymidine PET in oncology

PET Imaging During Radiotherapy of Head and Neck Cancer

Contact Info

Product

Resources

About