caa a22 4500 445334452 CHVBK 20180317142749.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1743-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1743-y Molecular Imaging of Proliferation and Glucose Utilization: Utility for Monitoring Response and Prognosis after Neoadjuvant Therapy in Locally Advanced Gastric Cancer [Elektronische Daten] [Katja Ott, Ken Herrmann, Tibor Schuster, Rupert Langer, Karen Becker, Hinrich Wieder, Hans-Jürgen Wester, Jörg-Rüdiger Siewert, Christian Büschenfelde, Andreas Buck, Dirk Wilhelm, Matthias Ebert, Christian Peschel, Markus Schwaiger, Florian Lordick, Bernd Krause] Background: Metabolic imaging of gastric cancer is limited due to the 30% of primary tumors that are not 18F-fluorodeoxyglucose (FDG) avid. In contrast, the proliferation marker 18F-fluorothymidine (FLT) has been shown to visualize also non-FDG-avid gastric tumors. In this study we tested whether FLT-positron emission tomography (PET) can improve the predictive potential of molecular imaging for assessing response to neoadjuvant therapy in gastric cancer compared with FDG-PET. Methods: 45 patients with gastric cancer underwent FDG- and FLT-PET before and 2weeks after initiation of chemotherapy. FDG/FLT-PET findings and Ki67 immunohistochemistry were correlated with clinical and histopathological response and survival. Results: 14 patients had non-FDG-avid tumors, whereas all tumors could be visualized by FLT-PET. No significant association of clinical or histopathological response with any of the analyzed metabolic parameters [initial standardized uptake value (SUV), SUV after 2weeks, change of SUV for FDG/FLT] was found. Univariate Cox regression analysis for Ki67 and metabolic parameters revealed significant prognostic impact for survival only for FLT SUVmean day 14 (p=0.048) and Ki67 (p=0.006). Multivariate Cox regression analysis (including clinical response, Lauren type, ypN category, and FLT SUVmean day 14) revealed Lauren type and FLT SUVmean day 14 as the only significant prognostic factors (p=0.006, p=0.002). Conclusions: FLT uptake 2weeks after initiation of therapy was shown to be the only imaging parameter with significant prognostic impact. Neither FLT-PET nor FDG-PET were correlated with histopathological or clinical response. However, these data must be interpreted with caution due to the single-center trial study design, relatively short follow-up, poor response rates, and unfavorable prognosis. Society of Surgical Oncology, 2011 Ott Katja Department of Surgery, University of Heidelberg, Heidelberg, Germany aut Herrmann Ken Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut Schuster Tibor Institute of Medical Statistics and Epidemiology, Technische Universitaet Muenchen, Munich, Germany aut Langer Rupert Institute of Pathology, Technische Universitaet Muenchen, Munich, Germany aut Becker Karen Institute of Pathology, Technische Universitaet Muenchen, Munich, Germany aut Wieder Hinrich Institute of Radiology, Technische Universitaet Muenchen, Munich, Germany aut Wester Hans-Jürgen Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut Siewert Jörg-Rüdiger Directorate, University of Heidelberg, Heidelberg, Germany aut Büschenfelde Christian Department of Internal Medicine III (Hematology/Oncology), Technische Universitaet Muenchen, Munich, Germany aut Buck Andreas Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut Wilhelm Dirk Department of Surgery, Technische Universitaet Muenchen, Munich, Germany aut Ebert Matthias Department of Internal Medicine II (Gastroenterology), Technische Universitaet Muenchen, Munich, Germany aut Peschel Christian Department of Internal Medicine III (Hematology/Oncology), Technische Universitaet Muenchen, Munich, Germany aut Schwaiger Markus Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut Lordick Florian Medizinische Klinik III, Klinikum Braunschweig, Brunswick, Germany aut Krause Bernd Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3316-3323 1068-9265 18:12<3316 2011 18 10434 https://doi.org/10.1245/s10434-011-1743-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1743-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ott Katja Department of Surgery, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Herrmann Ken Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Schuster Tibor Institute of Medical Statistics and Epidemiology, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Langer Rupert Institute of Pathology, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Becker Karen Institute of Pathology, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Wieder Hinrich Institute of Radiology, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Wester Hans-Jürgen Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Siewert Jörg-Rüdiger Directorate, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Büschenfelde Christian Department of Internal Medicine III (Hematology/Oncology), Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Buck Andreas Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Wilhelm Dirk Department of Surgery, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Ebert Matthias Department of Internal Medicine II (Gastroenterology), Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Peschel Christian Department of Internal Medicine III (Hematology/Oncology), Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Schwaiger Markus Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Lordick Florian Medizinische Klinik III, Klinikum Braunschweig, Brunswick, Germany aut NATIONALLICENCE 700 1- Krause Bernd Department of Nuclear Medicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3316-3323 1068-9265 18:12<3316 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer