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Comparison between 18F-FDG and Alternative Tracers for the Assessment of Hematological Ma-Lignancies

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Special Issue Editors

Special Issue Information

Dear Colleagues,

nuclear medicine evolves really fast and new positron emitters tracers are available year after year. Starting from preclinical evaluation, these radiopharmaceuticals are then used for clinical assessment in a high variety of diagnostic fields, including neoplasms, inflammatory or infectious diseases. Positron emission tomography/computed tomography (PET/CT) is moreover becoming pivotal for the assessment of many disorders and hematology is one of the main field of application of such diagnostic procedure. In this setting, lymphomas and related conditions are normally assessed with 18F-fluorodeoxyglucose (18F-FDG) PET/CT that is also able to give fundamental prognostic data, guiding the choice of the correct therapy. Many tracers are starting however to be used for the evaluation of hematological malignancies and for this Special Issue, I would like to invite authors to submit studies focusing on the use of these new tracers for the assessment of such disorders. Authors are welcome to cover other specific topics that have not been mentioned but fall within the theme of the Special Issue.

Dr. Francesco Dondi
Dr. Domenico Albano
Guest Editors

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Keywords

PET/CT
18F-FDG
lymphoma
FAPI
pentixafor positron emission tomography

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Review

10 pages, 256 KiB

Open AccessReview

Emerging Role of [¹⁸F]FLT PET/CT in Lymphoid Malignancies: A Review of Clinical Results

by Anna Giulia Nappi, Giulia Santo, Lorenzo Jonghi-Lavarini, Alberto Miceli, Achille Lazzarato, Flavia La Torre, Francesco Dondi and Joana Gorica

Hematol. Rep. 2024, 16(1), 32-41; https://doi.org/10.3390/hematolrep16010004 - 11 Jan 2024

Viewed by 807

Abstract

Fluorine-18 fluorodeoxyglucose ([¹⁸F]FDG) is nowadays the leading positron emission tomography (PET) tracer for routine clinical work-ups in hematological malignancies; however, it is limited by false positive findings. Notably, false positives can occur in inflammatory and infective cases or in necrotic tumors that are infiltrated by macrophages and other inflammatory cells. In this context, 3′-deoxy-3′-[¹⁸F]fluorothymidine ([¹⁸F]FLT) has been shown to be a promising imaging biomarker of hematological malignant cell proliferation. In this review, a total of 15 papers were reviewed to collect literature data regarding the clinical application of [¹⁸F]FLT PET/CT in hematological malignancies. This imaging modality seems to be a suitable tool for noninvasive assessment of tumor grading, also showing a correlation with Ki-67 immunostaining. Moreover, [¹⁸F]FLT PET/CT demonstrated high sensitivity in detecting aggressive lymphoma lesions, especially when applying a standardized uptake value (SUV) cutoff of 3. At baseline, the potential of [¹⁸F]FLT imaging as a predictive tool is demonstrated by the low tracer uptake in patients with a complete response. However, its use is limited in evaluating bone diseases due to its high physiological uptake in bone marrow. Interim [¹⁸F]FLT PET/CT (iFLT) has the potential to identify high-risk patients with greater precision than [¹⁸F]FDG PET/CT, optimizing risk-adapted therapy strategies. Moreover, [¹⁸F]FLT uptake showed a greater ability to differentiate tumor from inflammation compared to [¹⁸F]FDG, allowing the reduction of false-positive findings and making the first one a more selective tracer. Finally, FLT emerges as a superior independent predictor of PFS and OS compared to FDG and ensures a reliable early response assessment with greater accuracy and predictive value. Full article

(This article belongs to the Special Issue Comparison between 18F-FDG and Alternative Tracers for the Assessment of Hematological Ma-Lignancies)