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Figure 1.

Cellular pathway of thymidine with the interaction of pemetrexed indicated.

18F-FLT is not incorporated into DNA, as shown by the dotted arrow. Abbreviations: ENT, Equilibrative Nucleoside Transporter; TMP, Thymidine Monophosphate; TDP, Thymidine Diphosphate; TTP, Thymidine Triphospate; dNT, deoxyribonucleotidase.

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Table 1.

Patient demographics and characteristics.

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Table 2.

Results of standardized uptake value, non linear regression and Patlak Ki analysis per scan.

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Figure 2.

Correlation between SUV and Patlak at baseline and 4 hours after pemetrexed administration.

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Table 3.

Plasma to blood ratio and parent fraction per scan.

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Figure 3.

[18F]FLT PET scan.

Example of 18F-FLT uptake (A) before and (B) 4 hours after pemetrexed administration, showing an increase of 18F-FLT uptake in the primary tumor (arrow) of 32% after pemetrexed administration.

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Figure 4.

Change of 18F-FLT uptake.

Change of 18F-FLT uptake in SUV 40–60 min normalised to bodyweight (A) absolute difference, (B) percentage difference.

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Figure 5.

Mean SUV in muscle, liver, bone marrow and lung.

Mean SUV normalised to bodyweight for muscle, liver, bone marrow and lung at baseline and 4 hours after pemetrexed.

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Table 4.

Study results per patient.

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Figure 6.

Box plots with absolute differences in SUV.

SUV 40–60 min normalised to bodyweight for (A) tumor response after 6 weeks, (B) immunohistochemistry thymidylate synthase expression, (C) thymidylate synthase polymorphism, (D) methylenetetrahydrofolate reductase polymorphism.

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Figure 7.

Plasma deoxyuridine over time.

*Significant differences tested with paired t-test, p<0.05, indicated by the accolade.

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Figure 8.

Thymidilate synthase immunohistochemistry (20 ×).

In (A) scattered nuclear staining in >50% nuclei, and in (B) around 10% of the nuclei. Note in (A) also concomitant scattered cytoplasmic staining.

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