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. 2022 Jan-Dec:21:15330338221086396.
doi: 10.1177/15330338221086396.

Assessing Bone Marrow Activity with [ 18F]FLT PET in Patients with Essential Thrombocythemia and Prefibrotic Myelofibrosis: A Proof of Concept

Mohamed A Yassin  1 , Sadek A Nehmeh  2 , Abdulqadir J Nashwan  3 , Samah A Kohla  4 , Shehab F Mohamed  1 , Omar M Ismail  1 , Ahmad Al Sabbagh  4 , Dina S Soliman  4 , Lajos Szabados  5 , Hadi Fayad  6
Affiliations

Assessing Bone Marrow Activity with [ 18F]FLT PET in Patients with Essential Thrombocythemia and Prefibrotic Myelofibrosis: A Proof of Concept

Mohamed A Yassin et al. Technol Cancer Res Treat. 2022 Jan-Dec.

Abstract

Objectives: This study aims to assess the value of FLT-PET as a non-invasive tool to differentiate between patients with ET and Pre-PMF. This study is a pilot study to have a proof of concept only. Methods: This is a prospective, interventional study where a total of 12 patients were included. Each patient underwent FLT PET imaging as well as bone marrow examination (gold standard). In addition, semi-quantitative (SUVmax and SUVmean) measurements of FLT uptake in the liver, spleen, and Lspine, SUVmean, as well as the Total Lesion Glycolysis (TLG) of the Lspine were performed. Results from the two patient cohorts were compared using = Kruskal-Wallis statistical test. A P-value of <.05 is considered to be statistically significant. Results: The differences in FLT SUVmax and SUVmean measurements in the three organs (liver, spleen, and LSpine) between the ET and Pre-PMF patients were not statistically significant (P > .05). In contrast, TLG measurements in the LSpine were statistically different (P = .013), and therefore, compared to gold standard bone marrow results, TLG can separate ET and Pre-PMF patients. Conclusion: This study is a proof of concept about the potential to discriminate between ET and pre-PMF patients in a non-invasive way. TLG of the LSpine in FLT PET images is a potential quantitative parameter to distinguish between ET and pre-PMF patients.

Keywords: essential thrombocythemia; fluorothymidine F-18; positron emission tomography; prefibrotic myelofibrosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Labelling of L1 to L5 on CT and PET/CT images (B) Steps for the CT segmentation method (C) Steps for the PET segmentation method.
Figure 2.
Figure 2.
Example of 3 PET FLT patients with different bone marrow humerus / femur extension levels (A) 4/4 (B) 1/4 (C) 0/1
Figure 3.
Figure 3.
Kruscal Wallis test results when using the Lspine SUVmax to separate the ET and pre PMF groups. 0 value in the Diagnosis x-axis corresponds to ET and 1 value in the Diagnosis x-axis corresponds to PMF group. The Y axis corerponds to the SUVmax of the Lspine.
Figure 4.
Figure 4.
Kruscal Wallis test results when using the (A) Lspine SUVmean to separate the ET and pre PMF groups (B) Lspine volume to separate the ET and pre PMF groups. 0 value in the Diagnosis x-axis corresponds to ET and 1 value in the Diagnosis x-axis corresponds to PMF group. The Y axis corerponds to the SUVmean of the Lspine in A and to the Volume of the Lspine in B.
Figure 5.
Figure 5.
Kruscal Wallis test results when using the Lspine TLG to separate the ET and pre PMF groups. 0 value in the Diagnosis x-axis corresponds to ET and 1 value in the Diagnosis x-axis corresponds to PMF group. The Y axis corerponds to the TLG of the Lspine.
Figure 6.
Figure 6.
ROC curve analysis when using the Lspine TLG to separate the ET and pre-PMF groups.
See this image and copyright information in PMC

References

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