Imperial College London


Faculty of MedicineDepartment of Surgery & Cancer




+44 (0)20 3313 3759eric.aboagye




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BibTex format

author = {Aboagye, E and Sharma, R and Inglese, M and Dubash, S and Lu, H and Pinato, D and Patel, N and Chung, A and Sanghera, C and Tait, A and Mauri, F and Crum, W and Barwick, T},
doi = {10.2967/jnumed.119.240598},
journal = {The Journal of Nuclear Medicine},
title = {Monitoring response to transarterial chemoembolization in hepatocellular carcinoma using 18F-Fluorothymidine Positron Emission Tomography},
url = {},
year = {2020}

RIS format (EndNote, RefMan)

AB - Accurate disease monitoring is essential following transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) due to potential for profound adverse event and large variation in survival outcome. Post-treatment changes on conventional imaging can confound determination of residual/recurrent disease, magnifying the clinical challenge. Based on increased expression of thymidylate synthase (TYMS), thymidine kinase-1 (TK-1) and SLC29A1 (Equilibrative nucleoside transporter 1, ENT1) in HCC compared with liver tissue, we conducted a proof of concept study evaluating the efficacy of 18F-fluorothymidine (18F-FLT)-PET to assess response to TACE. As previous PET studies in HCC have been hampered by high background liver signal, we investigated if a temporal-intensity voxel-clustering (“Kinetic Spatial Filtering”) (KSF) improved lesion detection. Methods: A tissue microarray (TMA) was built from 36 HCC samples and matched surrounding cirrhotic tissue and was stained for thymidine kinase-1 (TK-1). A prospective study was conducted; eighteen patients with a diagnosis of HCC by American Association for the Study of Liver Diseases criteria (AALSD) who were eligible to treatment with TACE were enrolled. Patients underwent baseline conventional imaging and dynamic 18F-FLT-PET/KSF followed by TACE. Repeat imaging was performed 6-8 weeks post TACE. PET parameters were compared with modified-Response Evaluation in Solid Tumours (mRECIST) enhancement-based criteria. Results: Cancer Genome Atlas analysis revealed increased RNA expression of TYMS, TK-1 and SLC29A1 in HCC. TK-1 protein expression was significantly higher in HCC (p<0.05). The sensitivity of 18F-FLT-PET for baseline HCC detection was 73% (SUVmax of 9.7 ± 3.0; tumour to liver ratio of 1.2 ± 0.3). Application of KSF did not improve lesion detection. Lesion response following TACE by mRECIST criteria was 58% (14 patients with 24 lesions). A 30% reduction in mean 18F-FLT-PET uptake was o
AU - Aboagye,E
AU - Sharma,R
AU - Inglese,M
AU - Dubash,S
AU - Lu,H
AU - Pinato,D
AU - Patel,N
AU - Chung,A
AU - Sanghera,C
AU - Tait,A
AU - Mauri,F
AU - Crum,W
AU - Barwick,T
DO - 10.2967/jnumed.119.240598
PY - 2020///
SN - 0161-5505
TI - Monitoring response to transarterial chemoembolization in hepatocellular carcinoma using 18F-Fluorothymidine Positron Emission Tomography
T2 - The Journal of Nuclear Medicine
UR -
UR -
UR -
ER -