• 136: Reducing time to radical radiotherapy for lung cancer in Greater Manchester and East Cheshire.

      Bayman, Neil A; Edwards, Thomas; Murphy, Steven; Smith, Stephen C; Coote, Joanna H; Chan, Clara; Faivre-Finn, Corinne; Harris, Maggie A; Pemberton, Laura S; Sheikh, Hamid Y; et al. (2017-01)
    • 1371P Diagnostic and therapeutic strategies for elderly patients with advanced non-small cell lung cancer (NSCLC): results from an EORTC pan-European survey.

      Giaj-Levra, M; Menis, J; Luciani, A; De Maio, E; Hasan, B; Berghmans, T; Massiani, M; De Waele, M; Dingemans, A; Donckele, J; et al. (2017-09)
    • 1439O_PR Paediatric radiation therapy across Europe: a European questionnaire survey supported by the SIOPe, ESTRO, PROS and several national paediatric hematology-oncology societies (NAPHOS).

      Demoor-Goldschmidt, C; Carrie, C; Whitfield, Gillian A; Meijinders, P; Dieckmann, K; Timmermann, B; Zaletel, L; Banovic, P; Mekic, M; Lassen, Y; et al. (2017-09)
    • 1628O Development of the Manchester Cancer Research Centre Molecular Tumour Board for matching patients to clinical trials based on tumour and ctDNA genetic profiling.

      Gupta, Avinash; Ayub, Mahmood; Miller, Crispin J; Rothwell, Dominic G; Wallace, A; Jordan, Allan M; Cook, Natalie; Thistlethwaite, Fiona C; Carter, Louise; O’Brien, C; et al. (2017-09)
    • 163: LungTech stereotactic body radiotherapy (SBRT) of inoperable centrally located NSCLC: a phase II study in preparation for a randomised phase III trial.

      Faivre-Finn, Corinne; Ahmed, M; Franks, K; Ahmad, S; Harrow, S; University of Manchester, Division of Molecular and Clinical Cancer Science, Faculty of Biology, Medicine and Health, Manchester (2017-01)
    • 164: PARIS: a phase I study of pembrolizumab anti-PD-1 monoclonal antibody in combination with radiotherapy (RT) in locally advanced non-small cell lung cancer (NSCLC).

      Kordbacheh, Tiana; Chan, Clara; Bossons, Amy; Franks, K; McDonald, F; Forster, M; Mendes, R; Quezada, S; Dovedi, Simon J; Ralph, C; et al. (2017-01)
    • 168: PD-RAD: a translational study investigating PD-L1 expression after radiotherapy for non-small cell lung cancer (NSCLC).

      Kordbacheh, Tiana; Chan, Clara; Faivre-Finn, Corinne; Franks, K; McDonald, F; Forster, M; Mendes, R; Quezada, S; Dovedi, Simon J; Ralph, C; et al. (2017-01)
    • 169: Lung ART: phase III study comparing post-operative conformal radiotherapy to no post-operative radiotherapy in patients with completely resected non-small cell lung cancer and mediastinal N2 involvement.

      Faivre-Finn, Corinne; Le Pechoux, C; Edwards, J; Chappell, Brynn; Gornall, Hannah; Clinical Oncology, The Christie NHS Foundation Trust, Manchester (2017-01)
    • 171: ADSCaN: a randomised phase II study of accelerated, dose escalated, sequential chemo-radiotherapy in non-small cell lung cancer (NSCLC).

      Lawless, C; Landau, D; Faivre-Finn, Corinne; Boyd, K; Lester, J; Fenwick, J; Maguire, J; Mccartney, E; Paul, J; Parsons, E; et al. (2017-01)
    • 177Lu Dotatate vs. sequential 177Lu Dotatate and 90Y Dotatate: treatment outcomes for PRRT patients at the Christie - a clinical audit.

      Page, Emma; Tipping, Jill; Birch, Emma; Hamilton, David; Manoharan, Prakash; The Christie NHS Foundation Trust, Manchester, UK (2015)
    • (18)F-FLT PET imaging of cellular proliferation in pancreatic cancer.

      Lamarca, Angela; Asselin, Marie-Claude; Manoharan, Prakash; McNamara, Mairéad G; Trigonis, I; Hubner, Richard A; Saleem, Azeem; Valle, Juan W; Dept of Medical Oncology, The Christie NHS FT, Manchester (2015-12-29)
      Pancreatic ductal adenocarcinoma is known for its poor prognosis. Since the development of computerized tomography, magnetic resonance and endoscopic ultrasound, novel imaging techniques have struggled to get established in the management of patients diagnosed with pancreatic adenocarcinoma for several reasons. Thus, imaging assessment of pancreatic cancer remains a field with scope for further improvement. In contrast to cross-sectional anatomical imaging methods, molecular imaging modalities such as positron emission tomography (PET) can provide information on tumour function. Particularly, tumour proliferation may be assessed by measurement of intracellular thymidine kinase 1 (TK1) activity level using thymidine analogues radiolabelled with a positron emitter for use with PET. This approach, has been widely explored with [(18)F]-fluoro-3'-deoxy-3'-l-fluorothymidine ((18)F-FLT) PET. This manuscript reviews the rationale and physiology behind (18)F-FLT PET imaging, with special focus on pancreatic cancer and other gastrointestinal malignancies. Potential benefit and challenges of this imaging technique for diagnosis, staging and assessment of treatment response in abdominal malignancies are discussed.
    • [(18)F]DCFPyL PET-MRI/CT for unveiling a molecularly defined oligorecurrent prostate cancer state amenable for curative-intent ablative therapy: study protocol for a phase II trial

      Glicksman, RM; Metser, U; Valliant, J; Chung, PW; Fleshner, NE; Bristow, Robert G; Green, D; Finelli, A; Hamilton, R; Stanescu, T; et al. (2020)
    • 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) and the staging of early lung cancer.

      Laking, George R; Price, Patricia M; PET Oncology Group, Imperial College School of Medicine, London, UK. george.laking@csc.mrc.ac.uk (2001-09)
    • 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) for patients with biliary tract cancer: systematic review and meta-analysis

      Lamarca, Angela; Barriuso, Jorge; Chander, Amarjot; McNamara, Mairead G; Hubner, Richard A; O'Reilly, D; Manoharan, Prakash; Valle, Juan W; Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), School for Oncology and Developmental Biology (GROW), Maastricht, Netherlands (2019)
      INTRODUCTION: The role of 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) in the diagnosis and staging of patients with biliary tract cancer (BTCs) remains controversial. METHODS: This systematic-review and meta-analysis explored the diagnostic test accuracy (DTA) of 18FDG-PET as a diagnostic tool for diagnosis of primary tumour (T), lymph node (N), distant metastases (M) and relapsed disease (Rel). Subgroup analysis by study quality and BTC subtype were performed. Changes in management based on 18FDG-PET and impact of maximum standardized uptake values (SUVmax) on prognosis were also assessed. Random effects model was used for meta-analyses (MataDiSc v.1.4; Stata v.12; RevMan v.5; R-Studio v.8.1). RESULTS: Of 47 eligible studies, 2,125 patients were included. Pooled sensitivity (Se) and specificity (Sp) for patients with BTC were: T [Se 91.7% (95% CI 89.8-93.2); Sp 51.3% (95% CI 46.4-56.2); area under the curve (AUC) 0.8668]; N [Se 88.4% (95% CI 82.6-92.8); Sp 69.1%(95% CI 63.8-74.1); AUC 0.8519]; M [Se 85.4% (95% CI 79.5-90.2); Sp 89.7%(95% CI 86.0-92.7); AUC 0.9253]; Rel [Se 90.1% (95% CI 84.4-94.3); Sp 83.5%(95% CI 74.4-90.4); AUC 0.9592]. No threshold effect was identified. Meta-regression did not identify significant sources of heterogeneity. Sensitivity analysis did not reveal changes in results when analyses were limited to studies with low risk of bias/concern (high quality). Pooled proportion of change in management was 15% (95% CI 11-20); majority (78%) due to disease upstaging. Baseline high SUVmax was associated with worse survival (pooled HR of 1.79 (95% CI 1.37-2.33); p-value <0.001). CONCLUSIONS: There is evidence to support the incorporation of 18FDG-PET to the current standard of care staging imaging/diagnostic tests performed for the assessment of N, M and Rel to guide adequate treatment selection; especially if the identification of occult sites of disease would change management (i.e. surgery/local therapies) or if diagnosis of Rel remains unclear following standard of care imaging. The use of 18FDG-PET for diagnosis of primary tumour (T) in the absence of other disease sites or pathological confirmation remains controversial, due to low specificity. LAY SUMMARY: A positron emission tomography (PET scan), using 18F-fluorodeoxyglucose (18FDG), can help doctors identify areas of cancer in the body by highlighting "hot spots". These hotspots may be cancerous (true positive) but may also be non-cancerous, like inflammation (false positive). In this study all the published research of PET scans in patients with biliary tract cancer has been reviewed (systematic analysis) and the available information studied together (meta-analysis). We show that PET scans are useful to assess how far advanced the cancer is (by assessing spread to lymph glands and to other organs); and also useful to identify if the cancer has recurred (for example after surgery), thus helping doctors to make treatment decisions. However, it is not useful to first diagnose a biliary tract cancer due to the high chances of a "false positive" (diagnosing a cancer when there isn't one). Therefore, doctors should not rely on 18FDG-PET for diagnosis; a biopsy is still necessary.
    • [18F]DPA-714: direct comparison with [11C]PK11195 in a model of cerebral ischemia in rats.

      Boutin, H; Prenant, C; Maroy, R; Galea, J; Greenhalgh, A; Smigova, A; Cawthorne, C; Julyan, Peter J; Wilkinson, S; Banister, S; et al. (2013)
      Neuroinflammation is involved in several brain disorders and can be monitored through expression of the translocator protein 18 kDa (TSPO) on activated microglia. In recent years, several new PET radioligands for TSPO have been evaluated in disease models. [(18)F]DPA-714 is a TSPO radiotracer with great promise; however results vary between different experimental models of neuroinflammation. To further examine the potential of [(18)F]DPA-714, it was compared directly to [(11)C]PK11195 in experimental cerebral ischaemia in rats.
    • [18F]fludeoxyglucose PET/CT in small-cell lung cancer: analysis of the CONVERT randomized controlled trial

      Manoharan, Prakash; Salem, Ahmed; Mistry, H; Gornall, Michael; Harden, S; Julyan, Peter J; Locke, I; McAleese, J; McMenemin, R; Mohammed, N; et al. (2019)
      INTRODUCTION: We used phase-3 CONVERT trial data to investigate the impact of 18fludeoxyglucose (18F-FDG) PET/CT in small-cell lung cancer (SCLC). METHODS: CONVERT randomized limited-stage SCLC patients to twice-daily (45Gy in 30-fractions) or once-daily (66Gy in 33-fractions) chemoradiotherapy. Patients were divided into 2 groups in this unplanned analysis: those staged with conventional imaging (contrast-enhanced thorax and abdomen CT and brain imaging with/without bone scintigraphy) and those staged with 18F-FDG PET/CT in addition. RESULTS: 540 patients were analyzed. Compared to patients who underwent conventional imaging (n=231), patients also staged with 18F-FDG PET/CT (n=309) had smaller gross tumor volume (P=0·003), were less likely to have elevated pre-treatment serum lactate dehydrogenase (P=0·035), and received more chemotherapy (P=0·026). There were no significant differences in overall (HR 0·87 [95% CI 0·70-1·08]; P=0·192) and progression-free survival (HR 0·87 [95% CI 0·71-1·07]; P=0·198) between patients staged with or without 18F-FDG PET/CT. In the conventional imaging group, we found no survival difference between patients staged with or without bone scintigraphy. While there were no differences in delivered radiotherapy dose, 18F-FDG PET/CT-staged patients received lower normal tissue (lung, heart, and esophagus) radiation doses. Apart from higher incidence of late esophagitis in patients staged with conventional imaging (grade ?1: 19% vs 11%; P=0·012), the incidence of acute and late radiotherapy-related toxicities was not different between the two groups. CONCLUSION: In CONVERT, survival outcomes were not significantly different in patients staged with or without 18F-FDG PET/CT. However, this analysis cannot support the use or omission of 18F-FDG PET/CT due to study limitations.
    • [18f]fluorothymidine and [18f]fluorodeoxyglucose PET imaging demonstrates uptake and differentiates growth in neurofibromatosis 2 related vestibular schwannoma

      Anton-Rodriguez, Jose M; Lewis, D; Djoukhadar, I; Russell, D; Julyan, Peter J; Coope, D; King, A; Lloyd, S; Evans, D; Jackson, A; et al. (2019)
      OBJECTIVE: To investigate whether [F]fluorothymidine (FLT) and/or [F]fluorodeoxyglucose (FDG) positron emission tomography (PET) can differentiate growth in neurofibromatosis 2 (NF2) related vestibular schwannomas (VS) and to evaluate the importance of PET scanner spatial resolution on measured tumor uptake. METHODS: Six NF2 patients with 11 VS (4 rapidly growing, 7 indolent), were scanned with FLT and FDG using a high-resolution research tomograph (HRRT, Siemens) and a Siemens Biograph TrueV PET-CT, with and without resolution modeling image reconstruction. Mean, maximum, and peak standardised uptake values (SUV) for each tumor were derived and the intertumor correlation between FDG and FLT uptake was compared. The ability of FDG and FLT SUV values to discriminate between rapidly growing and slow growing (indolent) tumors was assessed using receiver operator characteristic (ROC) analysis. RESULTS: Tumor uptake was seen with both tracers, using both scanners, with and without resolution modeling. FDG and FLT uptake was correlated (R?=?0.67-0.86, p?<?0.01) and rapidly growing tumors displayed significantly higher uptake (SUVmean and SUVpeak) of both tracers (p?<?0.05, one tailed t test). All of the PET analyses performed demonstrated better discriminatory power (AUCROC range?=?0.71-0.86) than tumor size alone (AUCROC?=?0.61). The use of standard resolution scanner with standard reconstruction did not result in a notable deterioration of discrimination accuracy. CONCLUSION: NF2 related VS demonstrate uptake of both FLT and FDG, which is significantly increased in rapidly growing tumors. A short static FDG PET scan with standard clinical resolution and reconstruction can provide relevant information on tumor growth to aid clinical decision making.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.
    • 18fluorodeoxyglucose positron emission tomography in the prediction of relapse in patients with high-risk, clinical stage I nonseminomatous germ cell tumors: preliminary report of MRC Trial TE22--the NCRI Testis Tumour Clinical Study Group.

      Huddart, Robert A; O'Doherty, Michael J; Padhani, Anwar; Rustin, Gordon J S; Mead, Graham M; Joffe, Johnathan K; Vasey, Paul; Harland, Stephen J; Logue, John P; Daugaard, Gedske; et al. (2007-07-20)
      PURPOSE: There are several management options for patients with clinical stage I (CS1) nonseminomatous germ cell tumors (NSGCT); this study examined whether an 18fluorodeoxyglucose positron emission tomography (18FDG PET) scan could identify patients without occult metastatic disease for whom surveillance is an attractive option. METHODS: High-risk (lymphovascular invasion positive) patients with CS1 NSGCT underwent 18FDG PET scanning within 8 weeks of orchidectomy or marker normalization. PET-positive patients went off study; PET-negative patients were observed on a surveillance program. The primary outcome measure was the 2-year relapse-free rate (RFR) in patients with a negative PET scan (the negative predictive value). Assuming an RFR of 90% to exclude an RFR less than 80% with approximately 90% power, 100 PET-negative patients were required; 135 scanned patients were anticipated. RESULTS: Patients were registered between May 2002 and January 2005, when the trial was stopped by the independent data monitoring committee due to an unacceptably high relapse rate in the PET-negative patients. Of 116 registered patients, 111 underwent PET scans, and 88 (79%) were PET-negative (61% of preorchidectomy marker-negative patients v 88% of marker-positive patients; P = .002); 87 proceeded to surveillance, and one requested adjuvant chemotherapy. With a median follow-up of 12 months, 33 of 87 patients on surveillance relapsed (1-year RFR, 63%; 90% CI, 54% to 72%). CONCLUSION: Though PET identified some patients with disease not detected by computed tomography scan, the relapse rate among PET negative patients remains high. The results show that 18FDG PET scanning is not sufficiently sensitive to identify patients at low risk of relapse in this setting.
    • 19 The application of liquid biopsies in metastatic salivary gland cancer to identify candidate therapeutic targets.

      Metcalf, Robert; Mohan, S; Hilton, S; Pierce, J; Hudson, J; Betts, G; Chaturvedi, A; Homer, J; Leong, Hui Sun; Schofield, P; et al. (2017-10)