title: Assessing Bone Marrow Activity in Patients with Myelofibrosis: Results of a Pilot Study of18F-FLT PET.
abstract: An emerging noninvasive approach to assess tissue proliferation uses the PET tracer 3'-deoxy-3'-18F-fluorothymidine (18F-FLT). To evaluate the diagnostic value of this technique in myelofibrosis,18F-FLT PET imaging results were compared with bone marrow histology and bone marrow scintigraphy (BMS), the gold standard techniques in this clinical situation.Methods:Fifteen patients with histology-proven myelofibrosis were included consecutively in the study. Tracers' distributions were assessed using a visual grading assessment score of the uptake in the axial skeleton, proximal and distal limbs, liver, and spleen. This visual score was used to define patterns of tracer distribution and to compare the information provided either by PET or by BMS. A semiquantitative analysis with determination of SUVmaxin the same localizations was performed for18F-FLT PET.Results:The histology grade of fibrosis correlated with the SUVmaxin the axial skeleton (spine and iliac crests) and proximal limbs.18F-FLT uptake in these areas was much lower in patients with grade 3 fibrosis than in patients with grade 1 or 2 fibrosis.18F-FLT PET showed the same distribution of uptake as BMS in 13 of 14 patients (1 patient did not undergo BMS). In 1 patient,18F-FLT PET clearly showed an intense abnormal splenic uptake, whereas spleen uptake was inconclusive with BMS.Conclusion:18F-FLT PET appears to be a reliable and convenient technique to assess hematopoietic activity in bone marrow. It yields results close to those observed with BMS. In our study population,18F-FLT uptake in the axial skeleton and proximal limbs assessed by SUVmaxcorrelated with the grade of fibrosis. Thus,18F-FLT PET may be a useful tool to measure the severity of myelofibrosis, and to monitor noninvasively the patients' status during follow-up. Finally,18F-FLT PET may be foreseen as an alternative to BMS.
authors.affiliation: Service de Médecine Nucléaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France laetitia.vercellino@aphp.fr.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Vercellino
authors.affiliation: Service de Médecine Nucléaire, Hôpital Avicenne, Assistance-Publique Hôpitaux de Paris, Bobigny, France.
authors.forename: Matthieu John
authors.initials: MJ
authors.lastname: Ouvrier
authors.affiliation: Service de Médecine Nucléaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Barré
authors.affiliation: Unité de Biologie Cellulaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Cassinat
authors.affiliation: Service de Médecine Nucléaire, Hôpital Avicenne, Assistance-Publique Hôpitaux de Paris, Bobigny, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: de Beco
authors.affiliation: Unité de Biologie Cellulaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Dosquet
authors.affiliation: Service de Biostatistique et Information Médicale, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.|Université Paris-Diderot (Paris 7), Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: Service d'Anatomo-Pathologie, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France; and.
authors.forename: Véronique
authors.initials: V
authors.lastname: Meignin
authors.affiliation: Unité de Biologie Cellulaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.|Université Paris-Diderot (Paris 7), Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Chomienne
authors.affiliation: Service de Médecine Nucléaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.
authors.forename: Marie-Elisabeth
authors.initials: ME
authors.lastname: Toubert
authors.affiliation: Service de Médecine Nucléaire, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, Paris, France.|Université Paris-Diderot (Paris 7), Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Merlet
authors.affiliation: Université Paris-Diderot (Paris 7), Paris, France.|Centre d'Investigations Cliniques, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris France, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Kiladjian
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D015224:Dideoxynucleosides; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D055728:Primary Myelofibrosis / Q000000981:diagnostic imaging* / Q000473:pathology; D011379:Prognosis
chemical_list: D015224:Dideoxynucleosides; C002854:alovudine
keywords: 18F-FLT; PET; bone marrow imaging; myelofibrosis