¹⁸F-fluorothymidine PET for predicting survival in patients with resectable pancreatic cancer

Purpose: The aim of this study was to correlate preoperative 3'-deoxy-3'-[¹⁸F] fluorothymidine (FLT) uptake with the clinical outcome and survival in these patients after surgery. Materials and Methods: We performed a prospective analysis in 27 patients with adenocarcinoma of the pancreas (15 males, 12 females, mean age: 62 ± 13 years, range: 34 - 86 years). FLT PET (45 min p.i., 300 MBq FLT; ECAT HR+) images were acquired according to standard protocols. FLT uptake was quantified using standardised uptake values (SUV). Mean follow-up was 35 months (range 24-49). FLT uptake was correlated with survival using Martingale residual analysis. Results: Twenty-two patients died during follow-up. Mean overall survival was 18.8 months (SD: 12.7 months, 95% CI: 7.7, 26.5). FLT PET showed a mean SUV of 2.5 (range: 1.1 - 6.5). Martingale residual analysis revealed significant correlation between survival and FLT uptake (p = 0.045). The corresponding estimated hazard ratio per one-point increment of SUVmean was 1.298 (95% CI: 1.001, 1.685; p < 0.05). Conclusions: FLT PET allows risk stratification for death in patients with resectable pancreatic cancer prior to surgery.