Nucl Med Mol Imaging.  2009 Dec;43(6):535-542.

Pilot Study for the Prediction of Response to Radiotherapy Using [(18)F]Fluorothymidine PET in Nasopharyngeal Cancer: Comparison with [(18)F]FDG PET

Affiliations
  • 1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsryu2@amc.seoul.kr
  • 2Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
This study was performed to know whether [(18)F]Fluorothymidine (FLT) positron emission tomography (PET) can be used to monitor early response to radiotherapy in comparison with [(18)F]Fluorodeoxyglucose (FDG) PET, and to establish the optimal imaging time for prediction of therapy response.
MATERIALS AND METHODS
Two patients with nasopharyngeal cancer underwent serial FLT PET and FDG PET before and during radiotherapy. Three on-treatment FLT and FDG PET scans were performed on 1 week, 2 weeks and 3 weeks (at each time of 10 Gy, 20 Gy and 30 Gy delivered). The peak standardized uptake values (SUV(peak)) of primary tumors were measured on FLT and FDG PET. Then, percent changes of SUV(peak) after therapy were calculated.
RESULTS
In two patients, baseline values of SUV(peak) on FDT PET were higher than those on FLT PET (FLT vs FDG; 3.7 vs 5.0, and 5.7 vs 15.0). In patient 1, FLT SUV(peak) showed 78%, 78% and 84% of decrease on 1 week, 2 and 3 weeks after treatment, whereas FDG SUV(peak) showed 18%, 52% and 66% of decrease, respectively. In patient 2, FLT SUV(peak) showed 75%, 75% and 68% of decrease, whereas FDG SUV(peak) showed 51%, 49% and 58% of decrease, respectively. Both patients reached to complete remission after radiotherapy.
CONCLUSION
After radiotherapy, the decrease of FLT tumor uptake preceded the decrease of FDG tumor uptake in patients with nasopharyngeal cancer, and 1 week after therapy may be appropriate time for the assessment of early response. FLT PET might be more useful than FDG PET for monitoring early response to radiotherapy.

Keyword

[18F]Fluorothymidine; [18F]Fluorodeoxyglucose; PET; nasopharyngeal cancer; radiation therapy

MeSH Terms

Humans
Nasopharyngeal Neoplasms
Organothiophosphorus Compounds
Pilot Projects
Positron-Emission Tomography
Organothiophosphorus Compounds
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