Investigation of the pharmacokinetics of 3'-deoxy-3'-[18F]fluorothymidine uptake in the bone marrow before and early after initiation of chemoradiation therapy in head and neck cancer.
BACKGROUND
The kinetics of the bone marrow uptake of 3'-deoxy-3'-[(18)F]fluorothymidine (FLT) before and early after initiation of chemoradiation therapy was investigated in patients with head and neck cancer.


METHODS
Fourteen subjects with head and neck cancer underwent FLT positron emission tomography (PET) at baseline and after 10 Gy of radiation therapy. Thirteen subjects also received one cycle of platinum-based chemotherapy before the second FLT PET. Kinetic parameters, including the flux constant based on compartmental analysis (K(FLT)) and the Patlak constant (K(Patlak)) for cervical marrow, were calculated. Standardized uptake values (SUVs) for the cervical marrow (inside the radiation field) and lumbar spine marrow (outside the radiation field) were also determined.


RESULTS
There was a significant drop in FLT uptake in the bone marrow inside the radiation field. Mean pretreatment uptake values for the cervical spine were SUV=3.08+/-0.66, K(FLT)=0.045+/-0.016 min(-1) and K(Patlak)=0.039+/-0.013 min(-1). After treatment, these values were SUV=0.74+/-0.19, K(FLT)=0.011+/-0.005 min(-1) and K(Patlak)=0.005+/-0.002 min(-1). Compartmental analysis revealed a significant drop in k(3) in irradiated cervical marrow. FLT uptake in the bone marrow outside the radiation field exhibited a significantly smaller decrease.


CONCLUSIONS
There is a marked decrease in FLT uptake in irradiated bone marrow after 10 Gy of radiation therapy to the head and neck. The drop in FLT uptake in irradiated marrow is due to a significant decrease in the net phosphorylation rate of FLT.
Menda
Yusuf
Y
Division of Nuclear Medicine, Department of Radiology, University of Iowa Hospitals and Clinics Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA. yusuf-menda@uiowa.edu
Ponto
Laura L Boles
LL
Dornfeld
Kenneth J
KJ
Tewson
Timothy J
TJ
Watkins
G Leonard
GL
Gupta
Anjali K
AK
Anderson
Carryn
C
McGuire
Sarah
S
Schultz
Michael K
MK
Sunderland
John J
JJ
Graham
Michael M
MM
Buatti
John M
JM
D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D015224:Dideoxynucleosides / Q000493:pharmacokinetics*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013997:Time Factors
D015224:Dideoxynucleosides; C002854:alovudine
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