[18F]FLT-PET and [18F]FDG-PET in the evaluation of radiotherapy for laryngeal cancer

Oral Oncol. 2009 Dec;45(12):e211-5. doi: 10.1016/j.oraloncology.2009.07.008. Epub 2009 Aug 18.

Abstract

The evaluation of response to radiotherapy in patients with laryngeal cancer is a challenge because of the difficulty to differentiate between post-therapy changes and recurrent or residual tumor. Positron emission tomography is a non-invasive imaging tool that may be helpful in this differentiation. In this study, [(18)F]-fluoro-3'-deoxy-L-thymidine ([(18)F]FLT), a proliferation tracer is compared with 2-[(18)F]-fluoro-2-deoxy-D-glucose ([(18)F]FDG). Patients with primary laryngeal cancer, scheduled to undergo radiotherapy were included in this study. Patients underwent both [(18)F]FLT-PET and [(18)F]FDG-PET shortly before radiotherapy. Ten patients underwent [(18)F]FLT-PET and [(18)F]FDG-PET 2-3 months after radiotherapy. Scans were analyzed visually for areas of increased tracer uptake. The standardized uptake value (SUV) was measured as a semi-quantitative value of tracer uptake. Fourteen patients, all male, were included in this study. Both [(18)F]FLT-PET and [(18)F]FDG-PET showed increased tracer uptake in 12 out of 14 patients (86%). [(18)F]FDG uptake was significantly higher than [(18)F]FLT uptake (SUV(max): 4.5 vs. 2.4 (P=0.002); SUV(mean): 3.4 vs. 1.9 (P=0.002)). After radiotherapy, 3 patients had histologically proven residual or recurrent laryngeal cancer. [(18)F]FDG was true positive in 2 out of 3 patients, whereas [(18)F]FLT showed increased tracer uptake in only one. Of the remaining 7 patients, [(18)F]FLT was true negative in all, whereas [(18)F]FDG showed increased uptake in one (false positive). [(18)F]FLT-PET is feasible in visualizing laryngeal cancer and its evaluation of treatment. The overall uptake of this tracer is significantly lower as compared with [(18)F]FDG, but tumor to background ratios are comparable.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dideoxynucleosides* / pharmacokinetics
  • Feasibility Studies
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging*
  • Laryngeal Neoplasms / radiotherapy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Prospective Studies
  • Radiopharmaceuticals* / pharmacokinetics
  • Sensitivity and Specificity

Substances

  • Dideoxynucleosides
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • alovudine