UNLABELLED: This study compared the utility of 3'-deoxy-3'-(18)F-fluorothymidine PET ((18)F-FLT PET) with that of (18)F-FDG PET for assessment of the early locoregional clinical outcomes of chemoradiotherapy for head and neck squamous cell carcinomas. METHODS: From May 2006 to September 2010, 28 patients with head and neck squamous cell carcinomas underwent (18)F-FLT and (18)F-FDG PET before radiation therapy (RT), 4 wk after the initiation of RT, and 5 wk after completion of RT. PET images were evaluated qualitatively for regions of focally increased metabolism and were analyzed in relation to residual accumulation and local disease control. RESULTS: During RT, (18)F-FLT uptake decreased more significantly than (18)F-FDG uptake. (18)F-FLT accumulations disappeared in 34 of 54 lesions (63%), and negative predictive value was 97%. (18)F-FDG PET during RT also had a high negative predictive value (100%), but only 9 lesions (16%) showed complete absence of accumulation. The specificity and overall accuracy of (18)F-FLT PET were significantly higher than those of (18)F-FDG PET both during and after RT. In particular, high significance was attributable to the results of the evaluations of primary lesions. There were significant differences in 3-y local control between the residual-accumulation and no-accumulation groups on both posttreatment (18)F-FLT PET (P < 0.0001) and posttreatment (18)F-FDG PET (P = 0.0081). CONCLUSION: (18)F-FLT PET during RT and early follow-up facilitates the selection of optimal further therapy and the prediction of outcomes.
UNLABELLED: This study compared the utility of 3'-deoxy-3'-(18)F-fluorothymidine PET ((18)F-FLT PET) with that of (18)F-FDG PET for assessment of the early locoregional clinical outcomes of chemoradiotherapy for head and neck squamous cell carcinomas. METHODS: From May 2006 to September 2010, 28 patients with head and neck squamous cell carcinomas underwent (18)F-FLT and (18)F-FDG PET before radiation therapy (RT), 4 wk after the initiation of RT, and 5 wk after completion of RT. PET images were evaluated qualitatively for regions of focally increased metabolism and were analyzed in relation to residual accumulation and local disease control. RESULTS: During RT, (18)F-FLT uptake decreased more significantly than (18)F-FDG uptake. (18)F-FLT accumulations disappeared in 34 of 54 lesions (63%), and negative predictive value was 97%. (18)F-FDG PET during RT also had a high negative predictive value (100%), but only 9 lesions (16%) showed complete absence of accumulation. The specificity and overall accuracy of (18)F-FLT PET were significantly higher than those of (18)F-FDG PET both during and after RT. In particular, high significance was attributable to the results of the evaluations of primary lesions. There were significant differences in 3-y local control between the residual-accumulation and no-accumulation groups on both posttreatment (18)F-FLT PET (P < 0.0001) and posttreatment (18)F-FDG PET (P = 0.0081). CONCLUSION: (18)F-FLT PET during RT and early follow-up facilitates the selection of optimal further therapy and the prediction of outcomes.
Authors: Robert H Press; Hui-Kuo G Shu; Hyunsuk Shim; James M Mountz; Brenda F Kurland; Richard L Wahl; Ella F Jones; Nola M Hylton; Elizabeth R Gerstner; Robert J Nordstrom; Lori Henderson; Karen A Kurdziel; Bhadrasain Vikram; Michael A Jacobs; Matthias Holdhoff; Edward Taylor; David A Jaffray; Lawrence H Schwartz; David A Mankoff; Paul E Kinahan; Hannah M Linden; Philippe Lambin; Thomas J Dilling; Daniel L Rubin; Lubomir Hadjiiski; John M Buatti Journal: Int J Radiat Oncol Biol Phys Date: 2018-06-30 Impact factor: 7.038