Pilot study assessing 18F-fluorothymidine PET/CT in cervical and vaginal cancers before and after external beam radiation

Linda P. Cho, Chun K. Kim, Akila Viswanathan

Research output: Contribution to journalArticle

Abstract

Objective: The role of F-18-fluorothymidine (FLT) PET-CT imaging in the evaluation of gynecologic cancers has not been established. We sought to evaluate (FLT) PET-CT imaging in gynecologic cancers by comparing standard uptake values (SUVs) of FLT with F-18-fluorodeoxyglucose (FDG) PET in the primary tumor at diagnosis, and assess FLT uptake immediately following concurrent chemoradiotherapy (chemoRT). Methods: In this pilot study, patients treated for cervical (5) or vaginal (1) cancer underwent FLT-PET and FDG-PET scanning at diagnosis (FLT1 and FDG1). Five patients (4 cervical and 1 vaginal) also underwent FLT-PET within 1-3 weeks after chemoRT before brachytherapy (FLT2). Wilcoxon rank-sum test was used to compare the FLT1 and FDG1 parameters. Results: Median age at diagnosis was 61-years (range, 33-72). Cervical cancers were staged as IB2 (n = 1, 20%), IIB (n = 1, 20%), IIIB (n = 1, 20%) and IVA (n = 2, 40%) and the single vaginal cancer was staged IIIB. The most common histology was squamous cell carcinoma (n = 3, 50%) followed by adenocarcinoma (n = 2, 33%) and clear-cell adenosquamous carcinoma (n = 1, 17%). Median tumor SUVmax at diagnosis was 7.8 on FLT1-PET (3.9-14.2) versus 11.6 (5.9-23.2) on FDG1-PET (p = 0.15). Tumor SUVmax of FLT declined 54%-100% after chemoRT. Conclusion: The tumor SUV of FLT at diagnosis was lower than that of FDG-PET. FLT uptake was markedly decreased after chemoRT. Results indicate that there may not be a significant effect of inflammation on FLT uptake in gynecologic cancers. FLT may be a useful tool when assessing the effects of chemoRT on gynecologic malignancies and planning for postchemoRT brachytherapy treatments.

Original languageEnglish (US)
Pages (from-to)34-37
Number of pages4
JournalGynecologic Oncology Reports
Volume14
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Vaginal Neoplasms
Uterine Cervical Neoplasms
Radiation
Chemoradiotherapy
Neoplasms
Brachytherapy
Nonparametric Statistics
Adenosquamous Carcinoma
Fluorodeoxyglucose F18
Squamous Cell Carcinoma
Histology
Adenocarcinoma
Inflammation

Keywords

  • External-beam radiation therapy
  • FLT-PET
  • Gynecologic malignancies
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Pilot study assessing 18F-fluorothymidine PET/CT in cervical and vaginal cancers before and after external beam radiation. / Cho, Linda P.; Kim, Chun K.; Viswanathan, Akila.

In: Gynecologic Oncology Reports, Vol. 14, 01.11.2015, p. 34-37.

Research output: Contribution to journalArticle

@article{d756ee70cdee4ff0948dbff683eb0928,
title = "Pilot study assessing 18F-fluorothymidine PET/CT in cervical and vaginal cancers before and after external beam radiation",
abstract = "Objective: The role of F-18-fluorothymidine (FLT) PET-CT imaging in the evaluation of gynecologic cancers has not been established. We sought to evaluate (FLT) PET-CT imaging in gynecologic cancers by comparing standard uptake values (SUVs) of FLT with F-18-fluorodeoxyglucose (FDG) PET in the primary tumor at diagnosis, and assess FLT uptake immediately following concurrent chemoradiotherapy (chemoRT). Methods: In this pilot study, patients treated for cervical (5) or vaginal (1) cancer underwent FLT-PET and FDG-PET scanning at diagnosis (FLT1 and FDG1). Five patients (4 cervical and 1 vaginal) also underwent FLT-PET within 1-3 weeks after chemoRT before brachytherapy (FLT2). Wilcoxon rank-sum test was used to compare the FLT1 and FDG1 parameters. Results: Median age at diagnosis was 61-years (range, 33-72). Cervical cancers were staged as IB2 (n = 1, 20{\%}), IIB (n = 1, 20{\%}), IIIB (n = 1, 20{\%}) and IVA (n = 2, 40{\%}) and the single vaginal cancer was staged IIIB. The most common histology was squamous cell carcinoma (n = 3, 50{\%}) followed by adenocarcinoma (n = 2, 33{\%}) and clear-cell adenosquamous carcinoma (n = 1, 17{\%}). Median tumor SUVmax at diagnosis was 7.8 on FLT1-PET (3.9-14.2) versus 11.6 (5.9-23.2) on FDG1-PET (p = 0.15). Tumor SUVmax of FLT declined 54{\%}-100{\%} after chemoRT. Conclusion: The tumor SUV of FLT at diagnosis was lower than that of FDG-PET. FLT uptake was markedly decreased after chemoRT. Results indicate that there may not be a significant effect of inflammation on FLT uptake in gynecologic cancers. FLT may be a useful tool when assessing the effects of chemoRT on gynecologic malignancies and planning for postchemoRT brachytherapy treatments.",
keywords = "External-beam radiation therapy, FLT-PET, Gynecologic malignancies, Radiotherapy",
author = "Cho, {Linda P.} and Kim, {Chun K.} and Akila Viswanathan",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.gore.2015.10.003",
language = "English (US)",
volume = "14",
pages = "34--37",
journal = "Gynecologic Oncology Case Reports",
issn = "2211-338X",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Pilot study assessing 18F-fluorothymidine PET/CT in cervical and vaginal cancers before and after external beam radiation

AU - Cho, Linda P.

AU - Kim, Chun K.

AU - Viswanathan, Akila

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Objective: The role of F-18-fluorothymidine (FLT) PET-CT imaging in the evaluation of gynecologic cancers has not been established. We sought to evaluate (FLT) PET-CT imaging in gynecologic cancers by comparing standard uptake values (SUVs) of FLT with F-18-fluorodeoxyglucose (FDG) PET in the primary tumor at diagnosis, and assess FLT uptake immediately following concurrent chemoradiotherapy (chemoRT). Methods: In this pilot study, patients treated for cervical (5) or vaginal (1) cancer underwent FLT-PET and FDG-PET scanning at diagnosis (FLT1 and FDG1). Five patients (4 cervical and 1 vaginal) also underwent FLT-PET within 1-3 weeks after chemoRT before brachytherapy (FLT2). Wilcoxon rank-sum test was used to compare the FLT1 and FDG1 parameters. Results: Median age at diagnosis was 61-years (range, 33-72). Cervical cancers were staged as IB2 (n = 1, 20%), IIB (n = 1, 20%), IIIB (n = 1, 20%) and IVA (n = 2, 40%) and the single vaginal cancer was staged IIIB. The most common histology was squamous cell carcinoma (n = 3, 50%) followed by adenocarcinoma (n = 2, 33%) and clear-cell adenosquamous carcinoma (n = 1, 17%). Median tumor SUVmax at diagnosis was 7.8 on FLT1-PET (3.9-14.2) versus 11.6 (5.9-23.2) on FDG1-PET (p = 0.15). Tumor SUVmax of FLT declined 54%-100% after chemoRT. Conclusion: The tumor SUV of FLT at diagnosis was lower than that of FDG-PET. FLT uptake was markedly decreased after chemoRT. Results indicate that there may not be a significant effect of inflammation on FLT uptake in gynecologic cancers. FLT may be a useful tool when assessing the effects of chemoRT on gynecologic malignancies and planning for postchemoRT brachytherapy treatments.

AB - Objective: The role of F-18-fluorothymidine (FLT) PET-CT imaging in the evaluation of gynecologic cancers has not been established. We sought to evaluate (FLT) PET-CT imaging in gynecologic cancers by comparing standard uptake values (SUVs) of FLT with F-18-fluorodeoxyglucose (FDG) PET in the primary tumor at diagnosis, and assess FLT uptake immediately following concurrent chemoradiotherapy (chemoRT). Methods: In this pilot study, patients treated for cervical (5) or vaginal (1) cancer underwent FLT-PET and FDG-PET scanning at diagnosis (FLT1 and FDG1). Five patients (4 cervical and 1 vaginal) also underwent FLT-PET within 1-3 weeks after chemoRT before brachytherapy (FLT2). Wilcoxon rank-sum test was used to compare the FLT1 and FDG1 parameters. Results: Median age at diagnosis was 61-years (range, 33-72). Cervical cancers were staged as IB2 (n = 1, 20%), IIB (n = 1, 20%), IIIB (n = 1, 20%) and IVA (n = 2, 40%) and the single vaginal cancer was staged IIIB. The most common histology was squamous cell carcinoma (n = 3, 50%) followed by adenocarcinoma (n = 2, 33%) and clear-cell adenosquamous carcinoma (n = 1, 17%). Median tumor SUVmax at diagnosis was 7.8 on FLT1-PET (3.9-14.2) versus 11.6 (5.9-23.2) on FDG1-PET (p = 0.15). Tumor SUVmax of FLT declined 54%-100% after chemoRT. Conclusion: The tumor SUV of FLT at diagnosis was lower than that of FDG-PET. FLT uptake was markedly decreased after chemoRT. Results indicate that there may not be a significant effect of inflammation on FLT uptake in gynecologic cancers. FLT may be a useful tool when assessing the effects of chemoRT on gynecologic malignancies and planning for postchemoRT brachytherapy treatments.

KW - External-beam radiation therapy

KW - FLT-PET

KW - Gynecologic malignancies

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=84964870812&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964870812&partnerID=8YFLogxK

U2 - 10.1016/j.gore.2015.10.003

DO - 10.1016/j.gore.2015.10.003

M3 - Article

AN - SCOPUS:84964870812

VL - 14

SP - 34

EP - 37

JO - Gynecologic Oncology Case Reports

JF - Gynecologic Oncology Case Reports

SN - 2211-338X

ER -