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Mol Imaging Biol. 2018 Jun 18. doi: 10.1007/s11307-018-1226-7. [Epub ahead of print]

Mapping Bone Marrow Response in the Vertebral Column by Positron Emission Tomography Following Radiotherapy and Erlotinib Therapy of Lung Cancer.

Author information

1
Department of Medical Physics, Oslo University Hospital, PO Box 4953, Nydalen, N-0424, Oslo, Norway. azadeh.abravan@fys.uio.no.
2
Department of Physics, University of Oslo, Oslo, Norway. azadeh.abravan@fys.uio.no.
3
Department of Oncology, Oslo University Hospital, Oslo, Norway.
4
Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
5
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
6
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
7
Department of Medical Physics, Oslo University Hospital, PO Box 4953, Nydalen, N-0424, Oslo, Norway.
8
Department of Physics, University of Oslo, Oslo, Norway.

Abstract

PURPOSE:

To map functional bone marrow (BM) by 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography (PET) in the vertebral column of lung cancer patients prior to, during, and after treatment. Moreover, to identify radiation- and erlotinib-induced changes in the BM.

PROCEDURES:

Twenty-six patients with advanced non-small cell lung cancer, receiving radiotherapy (RT) alone or concomitantly with erlotinib, were examined by [18F]FDG PET before, during, and after treatment. A total of 61 [18F]FDG PET scans were analyzed. Vertebral column BM [18F]FDG standardized uptake value normalized to the liver (SUVBMLR) was used as uptake measure. Wilcoxon signed-rank test was used to assess changes in BM uptake of [18F]FDG between sessions. Effects of erlotinib on the BM activity during and after treatment were assessed using Mann-Whitney U test.

RESULTS:

A homogeneous uptake of [18F]FDG was observed within the vertebral column prior to treatment. Mean SUVBMLR (± S.E.M) in the body of thoracic vertebrae receiving a total RT dose of 10 Gy or higher was 0.64 ± 0.01, 0.56 ± 0.01, and 0.59 ± 0.01 at pre-, mid-, and post-therapy, respectively. A significant reduction in the mean SUVBMLR was observed from pre- to both mid- and post-therapy (p < 0.05). Mean SUVBMLR was significantly higher at post-therapy compared to mid-therapy for patients receiving erlotinib in addition to RT (p < 0.05).

CONCLUSIONS:

RT reduces BM [18F]FDG uptake in the vertebral column, especially in the high-dose region. Concomitant erlotinib may stimulate a recovery in BM [18F]FDG uptake from mid- to post-therapy.

TRIAL REGISTRATION:

NCT02714530. Registered 10 September 2015.

KEYWORDS:

Bone marrow; Erlotinib; FDG-PET; NSCLC; Thoracic radiotherapy; Vertebral column

PMID:
29916117
DOI:
10.1007/s11307-018-1226-7

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