Repeatability of 18F-FLT PET in a Multicenter Study of Patients with High-Grade Glioma
Quantitative 3′-deoxy-3′- 18 F-fluorothymidine ( 18 F-FLT) PET has potential as a noninvasive tumor biomarker for the objective assessment of response to treatment. To guide interpretation of these quantitative data, we evaluated the repeatability of 18 F-FLT PET as part of a multicenter trial invol...
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Veröffentlicht in: | The Journal of nuclear medicine (1978) 2017-03, Vol.58 (3), p.393-398 |
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Zusammenfassung: | Quantitative 3′-deoxy-3′-
18
F-fluorothymidine (
18
F-FLT) PET has potential as a noninvasive tumor biomarker for the objective assessment of response to treatment. To guide interpretation of these quantitative data, we evaluated the repeatability of
18
F-FLT PET as part of a multicenter trial involving patients with high-grade glioma.
Methods:
18
F-FLT PET was performed on 10 patients with recurrent high-grade glioma at 5 different institutions within the Adult Brain Tumor Consortium trial ABTC1101. Data were acquired according to a double baseline protocol in which PET examinations were repeated within 2 d of each other with no intervening treatment. On each of the 2 imaging days, dedicated brain PET was performed at 2 time points, 1 and 3 h after
18
F-FLT administration. Tumor SUVs and related parameters were measured at a central laboratory using various volumes of interest: isocontour at 30% of the maximum pixel (SUV
mean_30%
), gradient-based segmentation (SUV
mean_gradient
), the maximum pixel (SUV
max
), and a 1-mL sphere at the region of highest uptake (SUV
peak
). Repeatability coefficients (RCs) were calculated from the relative differences between corresponding SUV measurements obtained on the 2 d.
Results:
RCs for tumor SUVs were 22.5% (SUV
mean_30%
), 23.8% (SUV
mean_gradient
), 23.2% (SUV
max
), and 18.5% (SUV
peak
) at 1 h after injection. Corresponding data at 3 h were 22.4%, 25.0%, 27.3%, and 23.6%. Normalizing the tumor SUV data with reference to a background region improved repeatability, and the most stable parameter was the tumor-to-background ratio derived using SUV
peak
(RC, 16.5%).
Conclusion:
SUV quantification of
18
F-FLT uptake in glioma had an RC in the range of 18%–24% when imaging began 1 h after
18
F-FLT administration. The volume-of-interest methodology had a small but not negligible influence on repeatability, with the best performance obtained using SUV
peak
. Although changes in
18
F-FLT SUV after treatment cannot be directly interpreted as a change in tumor proliferation, we have established ranges beyond which SUV differences are likely due to legitimate biologic effects. |
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ISSN: | 0161-5505 1535-5667 |
DOI: | 10.2967/jnumed.116.178434 |