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2-[¹¹C]Thymidine Positron Emission Tomography Reproducibility in Humans

Authors' Affiliations: ¹ Department of Cancer Medicine, ² Medical Research Council Cyclotron Unit, and ³ Hammersmith Imanet, Imperial College London, Hammersmith Hospital, London, United Kingdom

Requests for reprints: Pat Price, Manchester Molecular Imaging Center, University of Manchester, Wolfson Building, 27 Palatine Road, Manchester M20 3LJ, United Kingdom. Phone: 44-161-446-8003; Fax: 44-161-446-8111; E-mail: pat.price{at}manchester.ac.uk.

Purpose: To evaluate the reproducibility of 2-[¹¹C]thymidine positron emission tomography (PET) scanning in patients with advanced intra-abdominal malignancies.

Patients and Methods: The reproducibility of 2-[¹¹C]thymidine PET was studied by comparing interpatient and intrapatient variability (coefficient of variability, COV) of both blood and tissue data. Arterial plasma metabolite levels were measured using on-line sampling and high-pressure liquid chromatography. 2-[¹¹C]Thymidine retention in tissue was measured as the standardized uptake value at the end of the scan (SUV_end), the area under the time-activity curve (AUC_{0-1 hour}), and the fractional retention of thymidine (FRT). A group of seven patients were scanned 1 week apart with no intervening anticancer therapy.

Results: There was interpatient variability in the levels of 2-[¹¹C]thymidine and its main metabolite, ¹¹CO₂, in plasma. Variability in 2-[¹¹C]thymidine PET data was greater between (COV: SUV_end = 38%, AUC_{0-1 hour} = 32%, FRT = 47%) than within (COV: SUV_end = 8%, AUC_{0-1 hour} = 2%, FRT = 9%) patients. There was a borderline significant difference between the paired tumor data for SUV_end (P = 0.041), but not for AUC_{0-1 hour} (P = 0.81) or FRT (P = 0.90). There was a good correlation between paired data for SUV_end (r = 0.98), AUC_{0-1 hour} (r = 0.99), and FRT (r = 0.95).

Conclusions: This is the first report showing that 2-[¹¹C]thymidine PET scanning is reproducible in humans. Repeat scanning of tumor proliferation using 2-[¹¹C]thymidine PET is feasible to perform in human intra-abdominal malignancies and should aid the future rapid assessment of antiproliferative tumor agents.

Key Words: 2-[¹¹C]thymidine • positron emission tomography • PET • spectral analysis

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