title: A pilot study of the diagnostic and prognostic values of FLT-PET/CT for pancreatic cancer: comparison with FDG-PET/CT.
abstract: The purpose of the study was to examine the diagnostic and prognostic values of18F-fluorothymidine (FLT)-PET/CT for pancreatic cancer by comparing with18F-fluorodeoxyglucose (FDG)-PET/CT.
  
  
  
  Fifteen patients with newly diagnosed pancreatic cancer underwent both FLT and FDG-PET/CT scans before treatment. The sensitivity, specificity, and accuracy in detecting nodal and distant metastases were compared between both scans using McNemar exact or χ2test. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic significance was assessed by Cox proportional hazards analysis.
  
  
  
  Both scans visualized all primary cancers. The sensitivity, specificity, and accuracy per patient basis for detecting nodal metastasis were equal and 63.6% (7/11), 100% (4/4), and 73.3% (11/15) for both scans, and for detecting distant metastasis were 100% (6/6), 88.9% (8/9), and 93.3% (14/15) for FDG-PET/CT, and 50.0% (3/6), 100% (9/9), and 80.0% (12/15) for FLT-PET/CT, respectively, without significant difference in each of them between both scans (p > 0.05). However, of 4 patients with multiple liver metastases, FDG-PET/CT was positive in all, but FLT-PET/CT was negative in three patients. At univariate analysis, only FLT-SUVmaxcorrelated with PFS (hazard ratio, 1.306, p = 0.048), and FDG total lesion glycolysis (TLG), FLT-SUVmax, and FLT-total lesion proliferation (TLP) correlated with OS (p = 0.021, p = 0.005, and p = 0.022, respectively). At bivariate analysis, FLT-SUVmaxwas superior to FDG-TLG or FLT-TLP for prediction of OS [HR (adjusted for FDG-TLG), 1.491, p = 0.034, HR (adjusted for FLT-TLP), 1.542, p = 0.023].
  
  
  
  FLT-PET/CT may have a potential equivalent to FDG-PET/CT for detecting primary and metastatic cancers except liver metastasis. FLT-SUVmaxcan provide the most significant prognostic information.
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. toyo.nakajo@dolphin.ocn.ne.jp.|Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan. toyo.nakajo@dolphin.ocn.ne.jp.
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nakajo
authors.affiliation: Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Kajiya
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tani
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Jinguji
authors.affiliation: Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakajo
authors.affiliation: Department of Gastroenterology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nihara
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Fukukura
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
mesh_terms: D000368:Aged; D015224:Dideoxynucleosides; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D010865:Pilot Projects; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D015224:Dideoxynucleosides; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C002854:alovudine
keywords: FDG; FLT; Pancreatic cancer; Prognosis; SUVmax