Early Response Assessment Using 3′-Deoxy-3′-[18F]Fluorothymidine-Positron Emission Tomography in High-Grade Non-Hodgkin's Lymphoma

• Published in: Clinical cancer research Vol. 13; no. 12; pp. 3552 - 3558
• Main Authors: HERRMANN, Ken, WIEDER, Hinrich A, PESCHEL, Christian, SCHWAIGER, Markus, DECHOW, Tobias, BUCK, Andreas K, SCHÖFFEL, Marion, KRAUSE, Bernd-Joachim, FEND, Falko, SCHUSTER, Tibor, ZUM BÜSCHENFELDE, Christian Meyer, WESTER, Hans-Jürgen, DUYSTER, Justus
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 15.06.2007
• Subjects: Adult; Aged; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Murine-Derived; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cyclophosphamide - therapeutic use; Doxorubicin - therapeutic use; Female; FLT-PET; Fluorine Radioisotopes; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; lymphoma; Lymphoma, Non-Hodgkin - diagnostic imaging; Lymphoma, Non-Hodgkin - drug therapy; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Positron-Emission Tomography; Prednisone - therapeutic use; Radiopharmaceuticals; Rituximab; therapy monitoring; Thymidine; Treatment Outcome; Vincristine - therapeutic use; Radionuclide study; Evaluation; Lymphoproliferative syndrome; Early; Malignant hemopathy; Non Hodgkin lymphoma; Positron emission tomography; High grade; High malignancy; Emission tomography
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-06-3025

Purpose: To evaluate 3′-deoxy-3′-[ 18 F]fluorothymidine-positron emission tomography (FLT-PET) for early monitoring response of high-grade non-Hodgkin's lymphoma to treatment with cyclophosphamide-adriamycin-vincristine-prednisone chemotherapy with or without rituximab immunotherapy (R-CHOP/CHOP). Experimental Design: Twenty-two patients with histologically proven high-grade non-Hodgkin's lymphoma scheduled to undergo first line treatment with R-CHOP/CHOP were included. All patients received baseline imaging before therapy with FLT-PET. For noninvasive assessment of treatment response, FLT-PET was repeated at following time points: group 1 ( n = 6), 1 and 6 weeks after R-CHOP/CHOP; group 2 ( n = 16), 2 days after rituximab and 2 days after CHOP application. Emission images were acquired 45 min after injection of 300 to 370 MBq of FLT. FLT uptake was quantified by region-of-interest technique on a lesion basis. Maximum standardized uptake values (SUV) for FLT were calculated using circular region of interest (diameter, 1.5 cm). Results: In all patients, morphologically proven lesions showed initially high FLT uptake (mean SUV, 8.1 ± 3.9). In group 1, mean FLT SUV decreased 7 days after R-CHOP/CHOP by 77% ( P < 0.001), the reduction in FLT SUV from baseline was 85% after 40 days ( P = 0.003). In group 2, FLT uptake in patients without dexamethasone pretreatment revealed no significant reduction after rituximab ( P = 0.3) but significantly decreased 2 days after CHOP to 32% compared with the baseline value ( P = 0.004). Conclusions: Administration of R-CHOP/CHOP is associated with an early decrease in lymphoma FLT uptake. Interestingly, there was no reduction of FLT uptake after rituximab alone, indicating no early antiproliferative effect of immunotherapy. FLT-PET seems to be promising for early evaluation of drug effects in lymphoma.