Correlation between Ki-67 immunohistochemistry and 18F-Fluorothymidine uptake in patients with cancer: A systematic review and meta-analysis

PET Imaging of Proliferation with Pyrimidines

“…Although the average uptake was lower with 18 F-FLT (SUV, 3.2) than with 18 F-FDG (SUV, 4.7), the lower background activity in normal breast tissue led to comparable conspicuity. 18 F-FLT uptake has been shown to correlate with histologic assessment of proliferation by Ki-67 in breast, lung, and brain cancers in a recent analysis of 27 such studies (7). Changes in 18 F-FLT uptake have been detected as early as 1 wk after chemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide (30).…”

Prognostic Value of 18F-FLT PET in Patients with Neuroendocrine Neoplasms: A Prospective Head-to-Head Comparison with 18F-FDG PET and Ki-67 in 100 Patients

“…Recently, 18 F-FDG PET demonstrated strong prognostic value in NENs, which may even exceed the value of the Ki-67 index and other traditional markers such as plasma chromogranin A or the presence of liver metastases (15).…”

“…18 F-FLT is trapped inside the cells after phosphorylation by thymidine kinase-1. Thymidine kinase-1 is upregulated during the S-phase of cell proliferation as a key enzyme in the DNA salvage pathway, hence although 18 F-FLT is not incorporated into DNA, it represents an indirect measurement of proliferation (16,17). 18 F-FLT PET could be considered a noninvasive Ki-67 index (18) and might add valuable information about tumor aggressiveness and prognosis.…”

“…The radiolabeled thymidine analog 39-deoxy-39- 18 F-fluorothymidine ( 18 F-FLT) is a tracer used for PET imaging of proliferation (16,17). 18 F-FLT is trapped inside the cells after phosphorylation by thymidine kinase-1.…”

PET/CT imaging in cancer: Current applications and future directions

“…Correlation of FLT uptake with the rate of cell proliferation in various tumor types has been demonstrated using histopathologic markers of cell proliferation, such as the Ki-67 labeling index, as the gold standard. 65 Unfortunately, most tumors demonstrate relatively low FLT uptake compared with FDG, which reduces the sensitivity of FLT-PET for detecting cancer. In addition, FLT demonstrates significant interfering physiologic activity in bone marrow and liver, and proliferating lymphocytes in reactive lymph nodes still have the potential to yield false-positive findings.…”