a Functional imaging techniques to personalise oncological treatments

Abstract

Biomarkers are an emerging concept in oncology and are required for stratified medicine. Prognostic and predictive biomarkers forecast outcome and guide therapy. Biological properties of tumours can be visualised using newer functional MRI or PET-CT techniques, which complement the structural information provided by contrast-enhanced CT/MRI. Specifically, the unique properties of the research PET tracer 18F-flurothymidine (FLT PET-CT), and diffusion-weighted (DW-MRI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) have shown promise in identifying early treatment responders after chemotherapy or radiotherapy. The increasing sophistication of radiotherapy techniques calls for better understanding of tumour biology so that this information can be integrated into individualised treatment plans. This dissertation describes studies aimed to improve knowledge of how to employ functional imaging techniques to individualise treatments for oncology patients. A portfolio of early phase clinical trials was established to evaluate imaging biomarkers in several solid tumour settings; pancreatic, thyroid, oropharyngeal and bladder cancer patients were studied. Additionally, data from a preclinical study evaluating the administration of thymidine phosphorylase to optimise FLT PET scanning are presented.