Clinical Research Papers:

18F-fluorothymidine PET for predicting survival in patients with resectable pancreatic cancer

Hinrich Wieder _, Ambros J. Beer, Jens Siveke, Tibor Schuster, Andreas K. Buck, Ken Herrmann and Jens C. Stollfuss

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Oncotarget. 2018; 9:10128-10134. https://doi.org/10.18632/oncotarget.24176

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Hinrich Wieder1,2, Ambros J. Beer1,9, Jens Siveke3, Tibor Schuster4, Andreas K. Buck5, Ken Herrmann6 and Jens C. Stollfuss7,8

1Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität, München, Munich, Germany

2Centre for Radiology and Nuclear Medicine, Grevenbroich, Germany

3Division of Solid Tumor Translational Oncology, German Cancer Consortium, Partner Site Essen, Universitätsklinikum Essen, Essen, Germany

4Department of Family Medicine, McGill University, Montreal, Quebec, Canada

5Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany

6Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany

7Institute for Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

8Department of Radiology and Nuclear Medicine, Klinikum Memmingen, Memmingen, Germany

9Department of Nuclear Medicine, Ulm University, Ulm, Germany

Correspondence to:

Hinrich Wieder, email: [email protected]

Keywords: FLT; PET; pancreas; predictive value; outcome prognosis

Received: August 16, 2017     Accepted: December 01, 2017     Published: January 12, 2018


Purpose: The aim of this study was to correlate preoperative 3'-deoxy-3'-[18F] fluorothymidine (FLT) uptake with the clinical outcome and survival in these patients after surgery.

Materials and Methods: We performed a prospective analysis in 27 patients with adenocarcinoma of the pancreas (15 males, 12 females, mean age: 62 ± 13 years, range: 34 – 86 years). FLT PET (45 min p.i., 300 MBq FLT; ECAT HR+) images were acquired according to standard protocols. FLT uptake was quantified using standardised uptake values (SUV). Mean follow-up was 35 months (range 24-49). FLT uptake was correlated with survival using Martingale residual analysis.

Results: Twenty-two patients died during follow-up. Mean overall survival was 18.8 months (SD: 12.7 months, 95% CI: 7.7, 26.5). FLT PET showed a mean SUV of 2.5 (range: 1.1 - 6.5). Martingale residual analysis revealed significant correlation between survival and FLT uptake (p = 0.045). The corresponding estimated hazard ratio per one-point increment of SUVmean was 1.298 (95% CI: 1.001, 1.685; p < 0.05).

Conclusions: FLT PET allows risk stratification for death in patients with resectable pancreatic cancer prior to surgery.

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