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Diagnostics 2019, 9(1), 17; https://doi.org/10.3390/diagnostics9010017

Evaluation of the Performance of 18F-Fluorothymidine Positron Emission Tomography/Computed Tomography (18F-FLT-PET/CT) in Metastatic Brain Lesions

1
Department of Clinical Physiology and Isotope, Kanta-Häme Central Hospital, 20 Ahvenistontie Str., 13530 Hameenlinna, Finland
2
Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Thessaly, Greece
3
PET/CT Department, Hygeia Hospital, 4 Erythrou Stavrou Str., 15123 Athens, Greece
4
Department of Hematology, Papageorgiou General Hospital, Perifereiaki Odos N. Efkarpias, 56429 Thessaloniki, Greece
5
Radiology Department, Hygeia Hospital, 4 Erythrou Stavrou Str., 15123 Athens, Greece
6
Medical Physics Department, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Mezourlo, 41110 Larissa, Thessaly, Greece
7
Department of Nuclear Medicine, Hygeia Hospital-Mitera, 4 Erythrou Stavrou Str., 15123 Athens, Greece
8
Nuclear Medicine Department, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Mezourlo, 41110 Larissa, Thessaly, Greece
*
Author to whom correspondence should be addressed.
Received: 24 December 2018 / Revised: 19 January 2019 / Accepted: 23 January 2019 / Published: 26 January 2019
(This article belongs to the Special Issue Brain Imaging)
Full-Text   |   PDF [796 KB, uploaded 26 January 2019]   |  

Abstract

18F-fluorothymidine (18F-FLT) is a radiolabeled thymidine analog that has been reported to help monitor tumor proliferation and has been studied in primary brain tumors; however, knowledge about 18F-FLT positron emission tomography/computed tomography (PET/CT) in metastatic brain lesions is limited. The purpose of this study is to evaluate the performance of 18F-FLT-PET/CT in metastatic brain lesions. A total of 20 PET/CT examinations (33 lesions) were included in the study. Semiquantitative analysis was performed: standard uptake value (SUV) with the utilization of SUVmax, tumor-to-background ratio (T/B), SUVpeak, SUV1cm3, SUV0.5cm3, SUV50%, SUV75%, PV50% (volume × SUV50%), and PV75% (volume × SUV75%) were calculated. Sensitivity, specificity, and accuracy for each parameter were calculated. Optimal cutoff values for each parameter were obtained. Using a receiver operating characteristic (ROC) curve analysis, the optimal cutoff values of SUVmax, T/B, and SUVpeak for discriminating active from non-active lesions were found to be 0.615, 4.21, and 0.425, respectively. In an ROC curve analysis, the area under the curve (AUC) is higher for SUVmax (p-value 0.017) compared to the rest of the parameters, while using optimal cutoff T/B shows the highest sensitivity and accuracy. PVs (proliferation × volumes) did not show any significance in discriminating positive from negative lesions. 18F-FLT-PET/CT can detect active metastatic brain lesions and may be used as a complementary tool. Further investigation should be performed. View Full-Text
Keywords: 18F-fluorothymidine positron emission tomography/computed tomography; brain metastases; FLT; PET/CT 18F-fluorothymidine positron emission tomography/computed tomography; brain metastases; FLT; PET/CT
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Nikaki, A.; Papadopoulos, V.; Valotassiou, V.; Efthymiadou, R.; Angelidis, G.; Tsougos, I.; Prassopoulos, V.; Georgoulias, P. Evaluation of the Performance of 18F-Fluorothymidine Positron Emission Tomography/Computed Tomography (18F-FLT-PET/CT) in Metastatic Brain Lesions. Diagnostics 2019, 9, 17.

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