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18F-Fludarabine PET for Lymphoma Imaging: First-in-Humans Study on DLBCL and CLL Patients
Sylvain Chantepie1, Narinée Hovhannisyan2, Stéphane Guillouet2
1Hematology Institute, CHU de Caen, Caen, France.
Summary
This first-in-human study shows 18F-fludarabine PET is a promising tool for imaging lymphoma. It offers a lower radiation dose than 18F-FDG PET and may improve detection of bone marrow infiltration.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiopharmaceutical Development
Background:
- Positron emission tomography (PET) imaging is crucial for lymphoma diagnosis and management.
- The standard radiotracer 18F-fluorodeoxyglucose (18F-FDG) has limitations and controversies in lymphoma imaging.
- 18F-fludarabine is a novel radiopharmaceutical developed for PET imaging of lymphoproliferative diseases.
Purpose of the Study:
- To evaluate the safety, biodistribution, tumor uptake, and radiation dosimetry of 18F-fludarabine in a first-in-human study.
- To compare 18F-fludarabine PET imaging with standard methods like 18F-FDG PET and CT in patients with lymphoma.
- To assess the potential of 18F-fludarabine as an innovative imaging agent for lymphoproliferative disorders.
Main Methods:
- Conducted a first-in-human PET/CT study involving 10 patients (5 with diffuse large B-cell lymphoma [DLBCL], 5 with chronic lymphocytic leukemia).
- Administered intravenous 18F-fludarabine (4 MBq/kg) and acquired six partial-body PET scans over 250 minutes.
- Evaluated tumor uptake (SUV), biodistribution, and radiation dosimetry; physical examination, lab studies, and CT were also performed. 18F-FDG PET was used for DLBCL patients.
Main Results:
- 18F-fludarabine showed increased uptake in abnormal sites in DLBCL patients, with significantly higher SUVs in lesions compared to normal tissues.
- Discrepancies between 18F-fludarabine and 18F-FDG PET were observed in 2 DLBCL patients.
- In chronic lymphocytic leukemia, 18F-fludarabine uptake corresponded to expected sites of disease, including splenic involvement and bone marrow, with no uptake in the heart or brain. Mean effective dose was 3.07 ± 0.81 mSv.
Conclusions:
- 18F-fludarabine PET demonstrates potential as a valuable imaging tool for lymphoproliferative diseases.
- The radiation dose associated with 18F-fludarabine is lower than that of 18F-FDG.
- The specificity for lymphoid cells, lack of accumulation in reactive tissues, and ability to detect bone marrow infiltration suggest an innovative role for 18F-fludarabine in lymphoma imaging.
![Visualization and Quantification of Brown and Beige Adipose Tissues in Mice using [18F]FDG Micro-PET/MR Imaging](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F62460.jpg&w=3840&q=50)
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