The prognostic value of F18 Fluorothymidine positron emission tomography for assessing the response of malignant pleural mesothelioma to chemotherapy - A prospective cohort study.
J Med Imaging Radiat Oncol
; 68(1): 57-66, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37898984
ABSTRACT
INTRODUCTION:
Malignant pleural mesothelioma is difficult to prognosticate. F18-Fluorodeoxyglucose positron emission tomography (FDG PET) shows promise for response assessment but is confounded by talc pleurodesis. F18-Fluorothymidine (FLT) PET is an alternative tracer specific for proliferation. We compared the prognostic value of FDG and FLT PET and determined the influence of talc pleurodesis on these parameters.METHODS:
Overall, 29 prospectively recruited patients had FLT PET, FDG PET and CT-scans performed prior to and post one chemotherapy cycle; 10 had prior talc pleurodesis. Patients were followed for overall survival. CT response was assessed using mRECIST. Radiomic features were extracted using the MiM software platform. Changes in maximum SUV (SUVmax), mean SUV (SUVmean), FDG total lesion glycolysis (TLG), FLT total lesion proliferation (TLP) and metabolic tumour volume (MTV) after one chemotherapy cycle.RESULTS:
Cox univariate analysis demonstrated FDG PET radiomics were confounded by talc pleurodesis, and that percentage change in FLT MTV was predictive of overall survival. Cox multivariate analysis showed a 10% increase in FLT tumour volume corresponded with 9.5% worsened odds for overall survival (P = 0.028, HR = 1.095, 95% CI [1.010, 1.187]). No other variables were significant on multivariate analysis.CONCLUSION:
This is the first prospective study showing the statistical significance of FLT PET tumour volumes for measuring mesothelioma treatment response. FLT may be better than FDG for monitoring mesothelioma treatment response, which could help optimise mesothelioma treatment regimes.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Mesotelioma Maligno
/
Mesotelioma
Limite:
Humans
Idioma:
En
Revista:
J Med Imaging Radiat Oncol
Assunto da revista:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
/
RADIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália