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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 4/2013

01-05-2013 | Original Article

Changes in 18F-fluorothymidine and 18F-fluorodeoxyglucose positron emission tomography imaging in patients with head and neck cancer treated with chemoradiotherapy

Authors: Hiroshi Hoshikawa, Terushige Mori, Takehito Kishino, Yuka Yamamoto, Ryuhei Inamoto, Kosuke Akiyama, Nozomu Mori, Yoshihiro Nishiyama

Published in: Annals of Nuclear Medicine | Issue 4/2013

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Abstract

Objective

This study compared change of 18F-fluorothymidine (FLT) uptake with that of 18F-fluorodeoxyglucose (FDG) in head and neck squamous cell cancer (HNSCC) patients during and after treatment and evaluated the utility for early monitoring of response to chemoradiotherapy.

Methods

Thirty patients with newly diagnosed HNSCCs treated with concurrent chemoradiotherapy underwent FLT and FDG PET in pre-treatment (PET1), mid-treatment (PET2) and post-treatment (PET3) stages. The PET images were evaluated quantitatively using maximum standardized uptake values (SUVs). Ratios between SUVs at PET2 and PET3 were also calculated.

Results

According to the SUVs, no significant differences were found with primary site location, cellular differentiation and T category in all PET scans. About a 78 % median decrease in FLT SUV was observed at the total dose (TD) of 30 Gy and no apparent change was observed thereafter. About a 40 % decrease in FDG SUV was observed at TD 30 Gy and significant decreases were then found at the 4- and 6-week time points after the therapy. FLT PET demonstrated no recurrence regions in patients with a PET3/PET2 ratio of <1.5. In comparison, FLT SUVs in PET3 with recurrence were increased more than three times. However, no significant difference was found between the values with recurrence and those with no recurrence in FDG PET.

Conclusion

FLT PET signal change preceded FDG PET change and the increase of FLT uptake after the therapy can imply recurrence or a residual tumor. FLT PET seems promising for early evaluation of chemoradiation effects in HNSCCs.
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Metadata
Title
Changes in 18F-fluorothymidine and 18F-fluorodeoxyglucose positron emission tomography imaging in patients with head and neck cancer treated with chemoradiotherapy
Authors
Hiroshi Hoshikawa
Terushige Mori
Takehito Kishino
Yuka Yamamoto
Ryuhei Inamoto
Kosuke Akiyama
Nozomu Mori
Yoshihiro Nishiyama
Publication date
01-05-2013
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 4/2013
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-013-0694-8

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