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Early assessment of treatment response in patients with AML using [F]FLT PET imaging
Authors:Matt VanderhoekMark B. Juckett  Scott B. PerlmanRobert J. Nickles  Robert Jeraj
Affiliation:a Department of Medical Physics, University of Wisconsin, Madison, WI, USA
b Department of Medicine, Section of Hematology and Oncology, University of Wisconsin, Madison, WI, USA
c Department of Radiology, Division of Nuclear Medicine, University of Wisconsin, Madison, WI, USA
Abstract:Assessment of treatment response in acute leukemia is routinely performed after therapy via bone marrow biopsy. We investigated the use of positron emission tomography (PET) for early assessment of treatment response in patients with acute myeloid leukemia (AML), using the proliferation marker 3′-deoxy-3′-[18F]fluoro-l-thymidine (FLT). Eight adult AML patients receiving induction chemotherapy underwent whole-body FLT PET/CT scans acquired at different time points during therapy. Patients who entered complete remission (CR) exhibited significantly lower FLT uptake in bone marrow than those patients with resistant disease (RD). In bone marrow, mean and maximum standardized uptake values were 0.8, 3.6 for CR and 1.6, 11.4 for RD, p < 0.001. FLT PET results for CR and RD patients were independent of assessment time point, suggesting that FLT PET scans acquired as early as 2 days after chemotherapy initiation may be predictive of clinical response. This pilot study suggests that FLT PET imaging during induction chemotherapy may serve as an early biomarker of treatment response in AML.
Keywords:Positron emission tomography (PET)   Acute myeloid leukemia (AML)   FLT   [18F]FLT   3&prime  -Deoxy-3&prime  -fluorothymidine   Treatment response   Radionuclide imaging
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