Predicting treatment response of soft tissue sarcomas to neoadjuvant therapy by imaging proliferation with a FLT-PET/CT scan: a pilot study

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Frederick C. Eilber, MD,  University of California Los Angeles
Recipient of the: $25,000 Shelby L. Richter Memorial Research Award

Although metabolic imaging with F18-fluorodeoxyglucose positron emission tomography(FDG-PET) is more sensitive than standard size-based criteria(RECIST) at monitoring response to therapy in high-grade soft tissue sarcomas(STS), its limited specificity restricts its utility as a functional bio-marker.

Hypothesis: Imaging proliferation with 18F-fluorodeoxythymidine-positron-emission-tomography(FLT-PET) will provide a more accurate assessment of response in patients with high-grade STS.

Aims:

1.  Evaluate the ability of changes in FLT uptake and size to predict histopathologic response to systemic neoadjuvant therapy.
2.  Compare change in FLT uptake with immunohistochemical markers of proliferation, cell-cycle-progression and apoptosis.
3.  Correlate changes in FLT uptake, size and histopathology with recurrence and survival.