UNLABELLED: Current clinical and imaging tools remain suboptimal for early assessment of prognosis and treatment response in aggressive lymphomas. PET with 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) can be used to measure tumor cell proliferation and treatment response. In a prospective study in patients with advanced-stage B-cell lymphoma, we investigated the prognostic and predictive value of (18)F-FLT PET in comparison to standard imaging with (18)F-FDG PET and clinical outcome. METHODS: Sixty-five patients were treated with an induction/consolidation regimen consisting of 4 cycles of R-CHOP-14 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) followed by 3 cycles of ICE (ifosfamide, carboplatin, etoposide). (18)F-FLT PET was performed at baseline and at interim (iPET) after 1-2 cycles of therapy. (18)F-FDG PET was performed at baseline, after cycle 4, and at the end of therapy. The relationship between PET findings, progression-free survival (PFS) and overall survival (OS) was investigated. RESULTS: With a median follow-up of 51 mo, PFS and OS were 71% and 86%, respectively. (18)F-FLT iPET, analyzed visually (using a 5-point score) or semiquantitatively (using SUV and ΔSUV) predicted both PFS and OS (P < 0.01 for all parameters). Residual (18)F-FLT SUVmax on iPET was associated with an inferior PFS (hazard ratio, 1.26, P = 0.001) and OS (hazard ratio, 1.27, P = 0.002). When (18)F-FDG PET was used, findings in the end of treatment scan were better predictors of PFS and OS than findings on the interim scan. Baseline PET imaging parameters, including SUV, proliferative volume, or metabolic tumor volume, did not correlate with outcome. CONCLUSION: (18)F-FLT PET after 1-2 cycles of chemotherapy predicts PFS and OS, and a negative (18)F-FLT iPET result may potentially help design risk-adapted therapies in patients with aggressive lymphomas. In contrast, the positive predictive value of (18)F-FLT iPET remains too low to justify changes in patient management.
UNLABELLED: Current clinical and imaging tools remain suboptimal for early assessment of prognosis and treatment response in aggressive lymphomas. PET with 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) can be used to measure tumor cell proliferation and treatment response. In a prospective study in patients with advanced-stage B-cell lymphoma, we investigated the prognostic and predictive value of (18)F-FLT PET in comparison to standard imaging with (18)F-FDG PET and clinical outcome. METHODS: Sixty-five patients were treated with an induction/consolidation regimen consisting of 4 cycles of R-CHOP-14 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) followed by 3 cycles of ICE (ifosfamide, carboplatin, etoposide). (18)F-FLT PET was performed at baseline and at interim (iPET) after 1-2 cycles of therapy. (18)F-FDG PET was performed at baseline, after cycle 4, and at the end of therapy. The relationship between PET findings, progression-free survival (PFS) and overall survival (OS) was investigated. RESULTS: With a median follow-up of 51 mo, PFS and OS were 71% and 86%, respectively. (18)F-FLTiPET, analyzed visually (using a 5-point score) or semiquantitatively (using SUV and ΔSUV) predicted both PFS and OS (P < 0.01 for all parameters). Residual (18)F-FLT SUVmax on iPET was associated with an inferior PFS (hazard ratio, 1.26, P = 0.001) and OS (hazard ratio, 1.27, P = 0.002). When (18)F-FDG PET was used, findings in the end of treatment scan were better predictors of PFS and OS than findings on the interim scan. Baseline PET imaging parameters, including SUV, proliferative volume, or metabolic tumor volume, did not correlate with outcome. CONCLUSION: (18)F-FLT PET after 1-2 cycles of chemotherapy predicts PFS and OS, and a negative (18)F-FLTiPET result may potentially help design risk-adapted therapies in patients with aggressive lymphomas. In contrast, the positive predictive value of (18)F-FLTiPET remains too low to justify changes in patient management.
Authors: Josef J Fox; Estelle Autran-Blanc; Michael J Morris; Somali Gavane; Sadek Nehmeh; André Van Nuffel; Mithat Gönen; Heiko Schöder; John L Humm; Howard I Scher; Steven M Larson Journal: J Nucl Med Date: 2011-10-07 Impact factor: 10.057
Authors: Karen Juul Mylam; Lale Kostakoglu; Martin Hutchings; Morton Coleman; Dominick Lamonica; Myron S Czuczman; Louis F Diehl; Anne L Nielsen; Paw Jensen; Annika Loft; Helle W Hendel; Victor Iyer; Sirpa Leppä; Sirkku Jyrkkiö; Harald Holte; Mikael Eriksson; Dorte Gillstrøm; Per B Hansen; Marko Seppänen; Karin Hjorthaug; Peter de Nully Brown; Lars M Pedersen Journal: Leuk Lymphoma Date: 2014-11-20
Authors: Steven M. Larson; Yusuf Erdi; Timothy Akhurst; Madhu Mazumdar; Homer A. Macapinlac; Ronald D. Finn; Cecille Casilla; Melissa Fazzari; Neil Srivastava; Henry W.D. Yeung; John L. Humm; Jose Guillem; Robert Downey; Martin Karpeh; Alfred E. Cohen; Robert Ginsberg Journal: Clin Positron Imaging Date: 1999-05
Authors: Ken Herrmann; Andreas K Buck; Tibor Schuster; Kathrin Abbrederis; Christina Blümel; Ivan Santi; Martina Rudelius; Hans-Jürgen Wester; Christian Peschel; Markus Schwaiger; Tobias Dechow; Ulrich Keller Journal: Oncotarget Date: 2014-06-30
Authors: Malik E Juweid; Andrew Quon; Ryogo Minamimoto; Luis Fayad; Julie Vose; Jane Meza; Ranjana Advani; Jordan Hankins; Felix Mottaghy; Homer Macapinlac; Alexander Heinzel Journal: Eur J Nucl Med Mol Imaging Date: 2021-04-28 Impact factor: 9.236