title: 18F-FLT PET imaging of cellular proliferation in pancreatic cancer.
abstract: Pancreatic ductal adenocarcinoma is known for its poor prognosis. Since the development of computerized tomography, magnetic resonance and endoscopic ultrasound, novel imaging techniques have struggled to get established in the management of patients diagnosed with pancreatic adenocarcinoma for several reasons. Thus, imaging assessment of pancreatic cancer remains a field with scope for further improvement. In contrast to cross-sectional anatomical imaging methods, molecular imaging modalities such as positron emission tomography (PET) can provide information on tumour function. Particularly, tumour proliferation may be assessed by measurement of intracellular thymidine kinase 1 (TK1) activity level using thymidine analogues radiolabelled with a positron emitter for use with PET. This approach, has been widely explored with [(18)F]-fluoro-3'-deoxy-3'-L-fluorothymidine ((18)F-FLT) PET. This manuscript reviews the rationale and physiology behind (18)F-FLT PET imaging, with special focus on pancreatic cancer and other gastrointestinal malignancies. Potential benefit and challenges of this imaging technique for diagnosis, staging and assessment of treatment response in abdominal malignancies are discussed.
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. Electronic address: angela.lamarca@christie.nhs.uk.
authors.forename: Angela
authors.initials: A
authors.lastname: Lamarca
authors.affiliation: University of Manchester Wolfson Molecular Imaging Centre (WMIC), Manchester, United Kingdom.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Asselin
authors.affiliation: Department of Radiology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Prakash
authors.initials: P
authors.lastname: Manoharan
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Institute of Cancer Sciences, Manchester Academic Health Science Centre, Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Mairéad G
authors.initials: MG
authors.lastname: McNamara
authors.affiliation: University of Manchester Wolfson Molecular Imaging Centre (WMIC), Manchester, United Kingdom.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Trigonis
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Hubner
authors.affiliation: University of Manchester Wolfson Molecular Imaging Centre (WMIC), Manchester, United Kingdom; Imanova Centre for Imaging Sciences, Imperial College Hammersmith Hospital, Du Cane Road, London W12 0NN, United Kingdom.
authors.forename: Azeem
authors.initials: A
authors.lastname: Saleem
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Institute of Cancer Sciences, Manchester Academic Health Science Centre, Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. Electronic address: juan.valle@manchester.ac.uk.
authors.forename: Juan W
authors.initials: JW
authors.lastname: Valle
mesh_terms: D049109:Cell Proliferation; D015224:Dideoxynucleosides; D006801:Humans; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals
chemical_list: D015224:Dideoxynucleosides; D019275:Radiopharmaceuticals
keywords: (18)F-FLT PET; Adenocarcinoma; Cancer; Pancreatic cancer; Proliferation; Thymidine