The main objective of the present study was to compare the 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]-FDG) and 3′-[ 18 F]fluoro-3′-deoxythymidine ([ 18 F]-FLT) PET imaging biomarkers for the longitudinal follow-up of small animal proton therapy studies in the context of hepatocellular carcinoma (HCC).
ProceduresSK-HEP-1 cells were injected into NMRI nude mice to mimic human HCC. The behavior of [ 18 F]-FDG and [ 18 F]-FLT tumor uptake was evaluated after proton therapy procedures. The proton single-fraction doses were 5, 10 and 20 Gy, with a dose rate of 10 Gy/min. The experimental protocol consisted of 8 groups of 10 mice, each group experiencing a particular dose/radiotracer condition. A reference PET exam was performed on each mouse the day before the irradiation procedure, followed by PET exams every three days up to 16 days after irradiation.
Results[ 18 F]-FDG uptake showed a linear dose-dependent increase in the first days after treatment (37%, p<0.05), while [ 18 F]-FLT uptake decreased in a dose-dependent manner (e.g 21% for 5Gy compared to 10 Gy, p=1.1e-2). At the later time point, [ 18 F]-FDG normalized activity showed an 85% decrease (p<0.01) for both 10 and 20 Gy doses and no variation for 5 Gy.Conversely, a significant 61% (p=0.002) increase was observed for [ 18 F]-FLT normalized activity at 5 Gy and no variation for higher doses.
ConclusionWe showed that the use of the [ 18 F]-FDG and [ 18 F]-FLT radiolabeled molecules can provide useful and complementary information for longitudinal follow-up of small animal proton therapy studies in the context of HCC. [ 18 F]-FDG PET imaging enables a treatment monitoring 3 several days / weeks postirradiation. On the other hand, [ 18 F]-FLT could represent a good candidate to monitor the treatment few days postirradiation, in the context of hypo-fractioned and close irradiations planning. This opens new perspectives in terms of treatment efficacy verification depending on the irradiation scheme.