Noninvasive detection of therapeutic cytolytic T cells with 18F-FHBG PET in a patient with glioma

Nat Clin Pract Oncol. 2009 Jan;6(1):53-8. doi: 10.1038/ncponc1278. Epub 2008 Nov 18.


Background: A 57-year-old man had been diagnosed with grade IV glioblastoma multiforme and was enrolled in a trial of adoptive cellular immunotherapy. The trial involved infusion of ex vivo expanded autologous cytolytic CD8+ T cells (CTLs), genetically engineered to express the interleukin 13 zetakine gene (which encodes a receptor protein that targets these T cells to tumor cells) and the herpes simplex virus 1 thymidine kinase (HSV1 tk) suicide gene, and PET imaging reporter gene.

Investigations: MRI, whole-body and brain PET scan with (18)F-radiolabelled 9-[4-fluoro-3-(hydroxymethyl)butyl]guanine ((18)F-FHBG) to detect CTLs that express HSV1 tk, and safety monitoring after injection of (18)F-FHBG.

Diagnosis: MRI detected grade III-IV glioblastoma multiforme plus two tumors recurrences that developed after resection of the initial tumor.

Management: Surgical resection of primary glioblastoma tumor, enrollment in CTL therapy trial, reresection of glioma recurrences, infusion of approximately 1 x 10(9) CTLs into the site of tumor reresection, and (18)F-FHBG PET scan to detect infused CTLs.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / immunology
  • Brain Neoplasms / therapy
  • Fluorine Radioisotopes / administration & dosage
  • Genetic Therapy*
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / immunology
  • Glioblastoma / therapy
  • Guanine / administration & dosage
  • Guanine / analogs & derivatives*
  • Herpesvirus 1, Human / genetics
  • Herpesvirus 1, Human / metabolism
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • T-Lymphocytes, Cytotoxic / immunology*
  • T-Lymphocytes, Cytotoxic / metabolism
  • Thymidine Kinase / genetics
  • Thymidine Kinase / metabolism


  • 9-(4-fluoro-3-hydroxymethylbutyl)guanine
  • Fluorine Radioisotopes
  • Guanine
  • Thymidine Kinase