Aim: To identify the relationship between tumour metabolism, vascularity, and survival in patients with primary solid tumours, including NSCLC, breast, colorectal and oesophageal cancers.
Method: Patients are scanned prior to treatment using a combination of whole body FDG PET/CT and CT perfusion of the primary tumour. A histological assessment of tumour vasculature and receptor status is performed on tumour specimens of surgical patients. Follow up information such as adjuvant/ neo adjuvant treatment modalities utilised, and survival information is also collected.
Previous Results: Some of the positive results identified so far include a dissociation between tumour vascularity and metabolism in subtypes of NSCLC, as well as significant relationships between tumour SUV and markers of angiogenesis such as VEGF in colorectal cancer, and CD105 count in breast cancer.
Future directions: We are currently investigating the use of FMiso in colorectal cancer, in order to determine level of tumour adaptability in a hypoxic environment. We are due to begin use of a F18 radiolabelled amino acid, called fluciclatide, which targets integrin AvB3, expressed during angiogenesis. Additionally we are using textural analysis software to identify the relationship between the texture of CT images, SUV, and survival. We are also looking at carrying out additional histological testing for BRAF, KRAS and PTEN.