The Evolution of Radionanotargeting towards Clinical Precision Oncology: A Festschrift in Honor of Kalevi Kairemo

Targeting Imaging Brain Lesions with PET/CT: F18-CH and F-18-FLT

Author(s): Alexandra Nikaki *

Pp: 309-316 (8)

DOI: 10.2174/9781681088655122010029

* (Excluding Mailing and Handling)


Passing to the era of molecular imaging and precision oncology, the
radiopharmaceuticals may play an incremental role in further revealing the nature of
the evaluated lesion. FLT, a radiolabeled thymidine analogue, and FCH, a radiolabeled
substance of the cell membrane phospholipids, have been more or less investigated in
the imaging, identification, and evaluation of brain tumor lesions. In our study, using a
Siemens Biograph LSO PET/CT 16 slices device, a Siemens multimodality workplace
(MMWP) system for brain analysis, and qualitative and semiquantitative analysis
(SUVmax, SUVpeak, T/B ratio), we investigated the role of these two
radiopharmaceuticals in primary and metastatic brain lesions, lymphomas as well as in
investigating neurological symptoms with inconclusive/indefinite evidence in the
conducted MRI. Using F-18-CH for PET/CT imaging, we found that there was FCH
uptake by active tumor sites, with no statistical significance in SUVmax, SUVpeak and
T/B ratio for the discrimination of the lesions between primary, metastatic and
lymphomas, (p > 0.05). However, recurrent primary lesions exhibited lower T/B and
SUVmax compared to the respective mean values of the metastatic ones. With the
utilization of F-18-FLT we concluded that it could discriminate between active from
non-active foci, while mean values of T/B and SUVmax were statistically significantly
higher for NHL compared to primary and metastatic tumors (p<0,001). There was a
tendency for significance for SUVmax and T/B between low and high-grade recurrent
primary tumors (p=0.08 and p=0.06, respectively) when excluding the outliers.
However, further investigation is required for definite conclusions.

Keywords: Brain Lesion, Brain Tumor, FCH, FLT, PET/CT.

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