Positron Emission Tomography Using Fluorothymidine F 18 in Finding Recurrent Disease in Patients With Gliomas

OBJECTIVES:

Primary

• Determine the safety of fluorothymidine F 18 for visual and dynamic brain tumor images in patients with glial neoplasms.
• Determine, preliminarily, the efficacy of this drug.

Secondary

• Compare, preliminarily, the efficacy of this drug to fludeoxyglucose F 18 in differentiating tumor recurrence from radiation necrosis.
• Determine the optimal time to image post injection of this drug.

OUTLINE: This is a pilot, nonrandomized study.

Patients receive fluorothymidine F 18 IV over 1 minute and then undergo positron emission tomography (PET) scanning of the brain over 2 hours.

After completion of the PET scan, patients are followed for at least 1 month.

PROJECTED ACCRUAL: A total of 12 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Radiological or established histological diagnosis of glioma

• WHO grade 2-4 disease
• Presence of a new or enlarging enhancing lesion on gadolinium-enhanced MRI after prior radiotherapy

• Differentiation of recurrent tumor from radiation necrosis is not possible
• No clinically significant signs of uncal herniation, including any of the following:

• Acute pupillary enlargement
• Rapidly developing (i.e., over hours) motor changes
• Rapidly decreasing level of consciousness

PATIENT CHARACTERISTICS:

• Platelet count ≥ 75,000/mm^3
• WBC ≥ 3,000/mm^3
• Gamma-glutamyl-transferase ≤ 5 times upper limit of normal (ULN)
• Absolute neutrophil count ≥ 1,500/mm^3
• Hemoglobin ≥ 10 g/dL
• SGOT and SGPT ≤ 2 times ULN
• Alkaline phosphatase ≤ 2 times ULN
• Lactic dehydrogenase ≤ 2 times ULN
• Direct and total bilirubin normal
• Amylase normal
• Haptoglobin normal
• Serum electrolytes normal
• CBC with platelets normal
• PT, PTT normal
• BUN and creatinine normal
• Not pregnant or lactating
• Urinalysis normal
• Negative pregnancy test
• Female patients must be postmenopausal for ≥ 1 year or surgically sterile, or on 1 of the following methods of birth control for ≥ 1 month: IUD, oral contraceptives, Depo-Provera, or Norplant

• These criteria can be waived at the discretion of the investigator if the patient's intracranial tumor is considered life threatening and the 1-month wait required is not in the best interest of the patient
• No known allergic or hypersensitivity reactions to previously administered radiopharmaceuticals
• No known HIV positivity
• Not requiring monitored anesthesia for positron emission tomography scanning

PRIOR CONCURRENT THERAPY:

• Concurrent biopsy or neurosurgical procedure for diagnostic and/or therapeutic purposes for this cancer allowed
• Concurrent surgery for this cancer allowed