A systematic review on [(18)F]FLT-PET uptake as a measure of treatment response in cancer patients.

Imaging biomarkers have a potential to depict the hallmarks of cancers that characterise cancer cells as compared to normal cells. One pertinent example is 3'-deoxy-3'-(18)F-fluorothymidine positron emission tomography ([(18)F]FLT-PET), which allows non-invasive in vivo assessment of tumour proliferation. Most importantly, [(18)F]FLT does not seem to be accumulating in inflammatory processes, as seen in [(18)F]-fludeoxyglucose, the most commonly used PET tracer for assessment of cell metabolism. [(18)F]FLT could therefore provide additional information about the tumour biology before, during and after treatment. This systematic review focuses on the use of [(18)F]FLT-PET tumour uptake values as a measure of tumour response to therapeutic interventions. The clinical studies which evaluated the role of [(18)F]FLT-PET as a measure of tumour response to treatment are summarised and the evidence linking [(18)F]FLT-PET tumour uptake values with clinical outcome is evaluated.

A literature review of the association between diffusion-weighted MRI derived apparent diffusion coefficient and tumour aggressiveness in pelvic cancer.

Diffusion-weighted magnetic resonance imaging (DW-MRI) is used extensively to improve tumour detection and localization because it offers excellent soft tissue contrast between malignant and non-malignant tissues. It also provides a quantitative biomarker; the apparent diffusion coefficient (ADC) can be derived from DW-MRI sequences using multiple diffusion weightings. ADC reflects the tumour microenvironment, e.g. cell membrane integrity and cellularity and has potential for reporting on tumour aggressiveness. This review focuses on the use of the DW-MRI derived imaging biomarker ADC to reflect tumour aggressiveness and its potential impact in managing pelvic cancer patients. The clinical studies which evaluate the role of ADC in pelvic tumours (prostate, bladder, rectal, ovary, cervix and uterus) are summarized and the evidence linking ADC values with tumour aggressiveness is evaluated.