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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Nakamoto, Y. Articles by Togashi, K. PubMed Articles by Nakamoto, Y. Articles by Togashi, K.

Post-therapeutic evaluation after neoadjuvant treatment: Which of the two should be prioritized, FLT-PET or FDG-PET?

¹ Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan

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Objectives: It has been reported that ¹⁸F-fluorothymidine (FLT) could be used for evaluating post-therapeutic status with less false positive, as compared to ¹⁸F-fluorodeoxyglucose (FDG). However, it remains unknown which is more accurate when they demonstrate discrepant results. The aim of this study was to assess the prevalence of discrepancy and which yielded more accurate diagnoses.

Methods: This retrospective study enrolled 11 patients with lung cancer (n=3), esophageal cancer (n=2), pancreatic cancer (n=3), oropharyngeal cancer (n=1), hypopharyngeal cancer (n=1), or cervical cancer (n=1), who underwent both FDG-PET and FLT-PET scans within one week after they have completed scheduled neoadjuvant treatment. Findings of both studies were correlated with final diagnoses determined by histopathology and/or clinical follow-up.

Results: A total of 32 lesions were analyzed, which were suspected viable by either scan or confirmed to be viable by final diagnoses. Of these 32 lesions, 27 were true positive lesions. There were eight inconsistent lesions (25%) in five patients. For these lesions, FLT-PET showed four false negatives while FDG-PET demonstrated one false negative in five true positive lesions. For the remaining three true negative lesions, one was false positive by FLT-PET and two were false positives by FDG-PET. The lesion-based sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FLT-PET were 41%, 60%, 44%, 85%, and 16%, respectively, while those of FDG-PET were 52%, 40%, 50%, 82%, and 13%, respectively.

Conclusions: Discrepancy occurred in one-fourth of the lesions, with the half accuracy of each study. Although FLT-PET had a little higher specificity, the overall diagnostic accuracy was almost comparable due to its lower sensitivity.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Nakamoto, Y. Articles by Togashi, K. PubMed Articles by Nakamoto, Y. Articles by Togashi, K.