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Porter JC, Ganeshan B, Win T, Fraioli F, Khan S, Rodriguez-Justo M, Endozo R, Shortman RI, Hoy LR, Maher TM, Groves AM. [ 18F]FDG PET/CT Signal Correlates with Neoangiogenesis Markers in Patients with Fibrotic Interstitial Lung Disease Who Underwent Lung Biopsy: Implication for the Use of PET/CT in Diffuse Lung Diseases. J Nucl Med 2024; 65:617-622. [PMID: 38485275 PMCID: PMC10995524 DOI: 10.2967/jnumed.123.266445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
The use of [18F]FDG PET/CT as a biomarker in diffuse lung diseases is increasingly recognized. We investigated the correlation between [18F]FDG uptake with histologic markers on lung biopsy of patients with fibrotic interstitial lung disease (fILD). Methods: We recruited 18 patients with fILD awaiting lung biopsy for [18F]FDG PET/CT. We derived a target-to-background ratio (TBR) of maximum pulmonary uptake of [18F]FDG (SUVmax) divided by the lung background (SUVmin). Consecutive paraffin-embedded lung biopsy sections were immunostained for alveolar and interstitial macrophages (CD68), microvessel density (MVD) (CD31 and CD105/endoglin), and glucose transporter 1. MVD was expressed as vessel area percentage per high-power field (Va%/hpf). Differences in imaging and angiogenesis markers between histologic usual interstitial pneumonia (UIP) and non-UIP were assessed using a nonparametric Mann-Whitney test. Correlation of imaging with angiogenesis markers was assessed using the nonparametric Spearman rank correlation. Univariate Kaplan-Meier survival analysis assessed the difference in the survival curves for each of the angiogenesis markers (separated by their respective optimal cutoff) using the log-rank test. Statistical analysis was performed using SPSS. Results: In total, 18 patients were followed for an average of 41.36 mo (range, 5.69-132.46 mo; median, 30.07 mo). Only CD105 MVD showed a significantly positive correlation with [18F]FDG TBR (Spearman rank correlation, 0.556; P < 0.05, n = 13). There was no correlation between [18F]FDG uptake and macrophage expression of glucose transporter 1. CD105 and CD31 were higher for UIP than for non-UIP, with CD105 reaching statistical significance (P = 0.011). In all patients, MVD assessed with either CD105 or CD31 quantification on biopsy predicted overall survival. Patients with CD105 MVD of less than 12 Va%/hpf or CD31 MVD of less than 35 Va%/hpf had a significantly better prognosis (no deaths during follow-up in the case of CD105) than did patients with higher scores of CD105 MVD (median survival, 35 mo; P = 0.041, n = 13) or CD31 MVD (median survival, 28 mo; P = 0.014, n = 13). Conclusion: Previous work has used [18F]FDG uptake in PET/CT as a biomarker in fILD. Here, we highlight a correlation between angiogenesis and [18F]FDG TBR. We show that MVD is higher for UIP than for non-UIP and is associated with mortality in patients with fILD. These data set the scene to investigate the potential role of vasculature and angiogenesis in fibrosis.
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Affiliation(s)
- Joanna C Porter
- CITR, UCL Respiratory, University College London, London, United Kingdom;
- Interstitial Lung Disease Centre, University College London Hospital, London, United Kingdom
| | - Balaji Ganeshan
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
| | - Thida Win
- Lister Hospital, North East Herts Trust, Stevenage, United Kingdom
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
| | - Saif Khan
- Research Department of Pathology, University College London, and Department of Histopathology, University College London Hospital, London, United Kingdom; and
| | - Manuel Rodriguez-Justo
- Research Department of Pathology, University College London, and Department of Histopathology, University College London Hospital, London, United Kingdom; and
| | - Raymond Endozo
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
| | - Robert I Shortman
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
| | - Luke R Hoy
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
| | - Toby M Maher
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London and University College London Hospital, London, United Kingdom
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Parghane RV, Suralkar T, Nikam D, Basu S. Evaluation of prostate-specific membrane antigen expression in locally advanced or metastatic breast carcinoma with 68 Ga-PSMA-11 positron-emission tomography/computed tomography imaging for potential theranostics. Nucl Med Commun 2024; 45:329-337. [PMID: 38312049 DOI: 10.1097/mnm.0000000000001820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND AND AIM Prostate-specific membrane antigen (PSMA) is ubiquitously expressed in tumor-associated neovasculature and may be a potential theranostic in many solid cancers, including breast carcinoma (BC). Herein, we analyzed the presence of PSMA in BC, through qualitative and quantitative parameters on 68 Ga-PSMA-11 positron-emission tomography/computed tomography (PET/CT), across various hormonal subtypes. METHODS This study examined 41 female patients of BC. All underwent 68 Ga-PSMA-11 PET/CT. For qualitative analysis, a visual estimation of PSMA expression was performed as per miPSMA scoring system (VISION trial) and a score ≥2 was considered eligible for lutetium-177 ( 177 Lu)-PSMA-617 radioligand therapy (Lu-PRLT). For quantitative analysis, maximum standardized uptake values (SUVmax) were determined and ratios >1 for SUVmax lesion to SUVmax liver were considered eligible for Lu-PRLT. PSMA expression was correlated with hormonal status using Chi-square test. The sensitivity, specificity and area under curve (AUC) of PSMA expression were determined using receiver-operating characteristics analysis ( P < 0.05). RESULTS A total of 19 patients (46.3%) and 15 patients (36.7%) in stage IV were found eligible for Lu-PRLT based on qualitative and quantitative analyses, respectively. Strong PSMA expression was detected in triple-negative and hormonal receptors-negative/human epidermal growth factor receptor 2-positive status on qualitative PSMA expression analysis. A sensitivity of 65.5%, specificity of 93.3% and AUC of 0.857 for SUVmax 6.5 on 68 Ga-PSMA-11 PET/CT were detected for PSMA expression for considering Lu-PRLT. CONCLUSION We found a modest number of BC patients suited for Lu-PRLT, indicating that PSMA PET/CT imaging may be a valuable modality for selecting theranostics in a carefully selected group of breast carcinoma.
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Affiliation(s)
- Rahul V Parghane
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India,
- Radiation Medicine Centre (BARC), Homi Bhabha National Institute, Mumbai, India and
| | - Tejal Suralkar
- Department of Radiation Oncology, the Cama & Albless Hospital, Mumbai, India
| | - Dilip Nikam
- Department of Radiation Oncology, the Cama & Albless Hospital, Mumbai, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India,
- Radiation Medicine Centre (BARC), Homi Bhabha National Institute, Mumbai, India and
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Diwanji D, Onishi N, Hathi DK, Lawhn-Heath C, Kornak J, Li W, Guo R, Molina-Vega J, Seo Y, Flavell RR, Heditsian D, Brain S, Esserman LJ, Joe BN, Hylton NM, Jones EF, Ray KM. 18F-FDG Dedicated Breast PET Complementary to Breast MRI for Evaluating Early Response to Neoadjuvant Chemotherapy. Radiol Imaging Cancer 2024; 6:e230082. [PMID: 38551406 PMCID: PMC10988337 DOI: 10.1148/rycan.230082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/30/2023] [Accepted: 02/16/2024] [Indexed: 04/02/2024]
Abstract
Purpose To compare quantitative measures of tumor metabolism and perfusion using fluorine 18 (18F) fluorodeoxyglucose (FDG) dedicated breast PET (dbPET) and breast dynamic contrast-enhanced (DCE) MRI during early treatment with neoadjuvant chemotherapy (NAC). Materials and Methods Prospectively collected DCE MRI and 18F-FDG dbPET examinations were analyzed at baseline (T0) and after 3 weeks (T1) of NAC in 20 participants with 22 invasive breast cancers. FDG dbPET-derived standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis (TLG) and MRI-derived percent enhancement (PE), signal enhancement ratio (SER), and functional tumor volume (FTV) were calculated at both time points. Differences between FDG dbPET and MRI parameters were evaluated after stratifying by receptor status, Ki-67 index, and residual cancer burden. Parameters were compared using Wilcoxon signed rank and Mann-Whitney U tests. Results High Ki-67 tumors had higher baseline SUVmean (difference, 5.1; P = .01) and SUVpeak (difference, 5.5; P = .04). At T1, decreases were observed in FDG dbPET measures (pseudo-median difference T0 minus T1 value [95% CI]) of SUVmax (-6.2 [-10.2, -2.6]; P < .001), SUVmean (-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009). Relative to nonresponsive tumors, responsive tumors showed a difference (95% CI) in percent change in SUVmax of -34.3% (-55.9%, 1.5%; P = .06) and in PEpeak of -42.4% (95% CI: -110.5%, 8.5%; P = .08). Conclusion 18F-FDG dbPET was sensitive to early changes during NAC and provided complementary information to DCE MRI that may be useful for treatment response evaluation. Keywords: Breast, PET, Dynamic Contrast-enhanced MRI Clinical trial registration no. NCT01042379 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Devan Diwanji
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Natsuko Onishi
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Deep K. Hathi
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Courtney Lawhn-Heath
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - John Kornak
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Wen Li
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Ruby Guo
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Julissa Molina-Vega
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Youngho Seo
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Robert R. Flavell
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Diane Heditsian
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Susie Brain
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Laura J. Esserman
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Bonnie N. Joe
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Nola M. Hylton
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Ella F. Jones
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Kimberly M. Ray
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
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Chen H, Fang Y, Gu J, Sun P, Yang L, Pan F, Wu H, Ye T. Dual-Layer Spectral Detector Computed Tomography Quantitative Parameters: A Potential Tool for Lymph Node Activity Determination in Lymphoma Patients. Diagnostics (Basel) 2024; 14:149. [PMID: 38248026 PMCID: PMC10814325 DOI: 10.3390/diagnostics14020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Dual-energy CT has shown promising results in determining tumor characteristics and treatment effectiveness through spectral data by assessing normalized iodine concentration (nIC), normalized effective atomic number (nZeff), normalized electron density (nED), and extracellular volume (ECV). This study explores the value of quantitative parameters in contrast-enhanced dual-layer spectral detector CT (SDCT) as a potential tool for detecting lymph node activity in lymphoma patients. A retrospective analysis of 55 lymphoma patients with 289 lymph nodes, assessed through 18FDG-PET/CT and the Deauville five-point scale, revealed significantly higher values of nIC, nZeff, nED, and ECV in active lymph nodes compared to inactive ones (p < 0.001). Generalized linear mixed models showed statistically significant fixed-effect parameters for nIC, nZeff, and ECV (p < 0.05). The area under the receiver operating characteristic curve (AUROC) values of nIC, nZeff, and ECV reached 0.822, 0.845, and 0.811 for diagnosing lymph node activity. In conclusion, the use of g nIC, nZeff, and ECV as alternative imaging biomarkers to PET/CT for identifying lymph node activity in lymphoma holds potential as a reliable diagnostic tool that can guide treatment decisions.
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Affiliation(s)
- Hebing Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Yuxiang Fang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Jin Gu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Peng Sun
- Clinical & Technical Support, Philips Healthcare, Floor 7, Building 2, World Profit Center, Beijing 100000, China;
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Hongying Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
| | - Tianhe Ye
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan 430022, China; (H.C.); (Y.F.); (J.G.); (L.Y.); (F.P.)
- Hubei Province Key Laboratory of Molecular Imaging, Jiefang Avenue #1277, Wuhan 430022, China
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Zheng X, Shi Y, Kulabieke D, Wang Z, Cheng Y, Qian J. Prognostic significance of 18F-Fluorodeoxyglucose positron-emission tomography parameters in patients with biliary tract cancers: a meta-analysis. BMC Med Imaging 2024; 24:9. [PMID: 38166643 PMCID: PMC10763065 DOI: 10.1186/s12880-023-01182-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Numerous previous studies have assessed the prognostic role of 18F-fluorodeoxyglucose positron-emission tomography (18F FDG PET) in patients with biliary tract cancer (BTC), but those results were inconsistent. The present study aims to determine the predictive value of 18F FDG PET in BTC patients via a meta-analysis. METHODS The underlying studies related to 18F FDG PET and BTC patients` outcomes were searched and identified in the online databases. The interested parameters include total lesion glycolysis (TLG), metabolic tumor volume (MTV), primary tumor and metastatic lymph node (LN) maximum standardized uptake value (SUVmax), as well as change of SUVmax (ΔSUVmax) during treatment. Overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were considered as the primary endpoints. Hazard ratio (HR) and corresponding 95% confidence intervals (CIs) were defined as the effective measure and calculated by a pooled analysis. Publication bias was assessed by funnel plot, Bagg's and Egger's tests. RESULTS Totally, 23 studies involving 1478 patients were included in the present meta-analysis. After a pooled analysis, it revealed that a high SUVmax was significantly associated with a poor OS (HR:2.07, 95%CI: 1.74-2.46, P = 0.000) and DFS (HR: 2.28, 95%CI: 1.53-3.41, P = 0.000). In addition, an increased TLG level contributed to a shorter OS (HR:1.91, 95%CI: 1.26-2.90, P = 0.002) and DFS (HR: 4.34, 95%CI: 1.42-13.27, P = 0.01). Moreover, we confirmed that an elevated MTV was significantly associated with increased mortality (HR:2.04, 95%CI:1.26-3.31, P = 0.004) and disease relapse (HR: 3.88, 95%CI:1.25-12.09, P = 0.019) risks. Besides, the present study uncovered that increased ΔSUVmax could predict poor OS (HR:1.26, 95%CI:1.06-1.50, P = 0.008) instead of PFS (HR: 1.96, 95%CI: 0.82-4.72, P = 0.280). Lastly, we found that LN SUVmax did not link to OS (HR: 1.49, 95%CI: 0.83-2.68, P = 0.178). No obvious publication bias was detected in the present study. CONCLUSION 18F FDG PET parameters, including SUVmax, TLG, MTV, and ΔSUVmax, could be applied as convenient and reliable factors for predicting BTC patients` outcomes.
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Affiliation(s)
- Xia Zheng
- Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China
| | - Yue Shi
- Dermatology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China
| | - Delida Kulabieke
- Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China
| | - Zihao Wang
- Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China
| | - Ying Cheng
- Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China
| | - Jun Qian
- Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China.
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Zhang L, Xu C, Zhang X, Wang J, Jiang H, Chen J, Zhang H. A novel analytical approach for outcome prediction in newly diagnosed NSCLC based on [ 18F]FDG PET/CT metabolic parameters, inflammatory markers, and clinical variables. Eur Radiol 2023; 33:1757-1768. [PMID: 36222865 DOI: 10.1007/s00330-022-09150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To develop a novel analytical approach based on 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) metabolic parameters, serum inflammatory markers, and clinical variables to improve the outcome prediction in NSCLC. METHODS A total of 190 newly diagnosed NSCLC patients who underwent pretreatment [18F]FDG PET/CT were retrospectively enrolled and divided into a training cohort (n = 127) and a test cohort (n = 63). Cox regression analysis was used to investigate the predictive values of PET metabolic parameters, inflammation markers, and clinical variables for progression-free survival (PFS) and overall survival (OS). Based on the results of multivariate analysis, PET-based, clinical, and combined models were constructed. The predictive performance of different models was evaluated using time-dependent ROC curve analysis, Harrell concordance index (C-index), calibration curve, and decision curve analysis. RESULTS The combined models incorporating SULmax, MTV, NLR, and ECOG PS demonstrated significant prognostic superiority over PET-based models, clinical models, and TNM stage in terms of both PFS (C-index: 0.813 vs. 0.786 vs. 0.776 vs. 0.678, respectively) and OS (C-index: 0.856 vs. 0.792 vs. 0.781 vs. 0.674, respectively) in the training cohort. Similar results were observed in the test cohort for PFS (C-index: 0.808 vs. 0.764 vs. 0.748 vs. 0.679, respectively) and OS (C-index: 0.836 vs. 0.785 vs. 0.726 vs. 0.660, respectively) prediction. The combined model calibrated well in two cohorts. Decision curve analysis supported the clinical utility of the combined model. CONCLUSIONS We reported a novel analytical approach combining PET metabolic information with inflammatory biomarker and clinical characteristics, which could significantly improve outcome prediction in newly diagnosed NSCLC. KEY POINTS • The nomogram incorporating SULmax, MTV, NLR, and ECOG PS outperformed the TNM stage for outcome prediction in patients with newly diagnosed NSCLC. • The established nomogram could provide refined prognostic stratification.
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Affiliation(s)
- Lixia Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, 310006, Zhejiang, China
| | - Caiyun Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, 310006, Zhejiang, China
| | - Xiaohui Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, 310009, Zhejiang, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, Zhejiang, China.
| | - Jing Wang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, 310009, Zhejiang, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, Zhejiang, China.
| | - Han Jiang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, 310009, Zhejiang, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, Zhejiang, China
| | - Jinyan Chen
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, 310006, Zhejiang, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, 310009, Zhejiang, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, Zhejiang, China.
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7
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Clinical Evaluation of Nuclear Imaging Agents in Breast Cancer. Cancers (Basel) 2022; 14:cancers14092103. [PMID: 35565232 PMCID: PMC9101155 DOI: 10.3390/cancers14092103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 12/07/2022] Open
Abstract
Precision medicine is the customization of therapy for specific groups of patients using genetic or molecular profiling. Noninvasive imaging is one strategy for molecular profiling and is the focus of this review. The combination of imaging and therapy for precision medicine gave rise to the field of theranostics. In breast cancer, the detection and quantification of therapeutic targets can help assess their heterogeneity, especially in metastatic disease, and may help guide clinical decisions for targeted treatments. Positron emission tomography (PET) or single-photon emission tomography (SPECT) imaging has the potential to play an important role in the molecular profiling of therapeutic targets in vivo for the selection of patients who are likely to respond to corresponding targeted therapy. In this review, we discuss the state-of-the-art nuclear imaging agents in clinical research for breast cancer. We reviewed 17 clinical studies on PET or SPECT agents that target 10 different receptors in breast cancer. We also discuss the limitations of the study designs and of the imaging agents in these studies. Finally, we offer our perspective on which imaging agents have the highest potential to be used in clinical practice in the future.
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8
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Hua J, Li L, Liu L, Liu Q, Liu Y, Chen X. The diagnostic value of metabolic, morphological and heterogeneous parameters of 18F-FDG PET/CT in mediastinal lymph node metastasis of non-small cell lung cancer. Nucl Med Commun 2021; 42:1247-1253. [PMID: 34269750 DOI: 10.1097/mnm.0000000000001456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the value of PET/CT metabolic, morphological and heterogeneous parameters in the diagnosis of 18F-FDG positive mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC). PATIENTS AND METHODS A total of 156 patients with pathologically diagnosed NSCLC and underwent 18F-FDG PET/CT scans were enrolled in this study. Mediastinal lymph nodes with 18F-FDG uptake greater than the mediastinum were analyzed. The metabolic parameters of maximum and mean standardized uptake value (SUVmax, SUVmean), SUVratio (node SUVmax/mediastinum SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), morphological parameters of maximum short diameter (Dmin), CT values and metabolic heterogeneity parameter of coefficient of variation (COV) were measured. The performance of each parameter and their combinations for diagnosis of lymph node metastasis was evaluated through receiver operating characteristic (ROC) curves and binary logistic regression analysis. RESULTS There were 206 lymph nodes with pathological evidence included in the study, including 103 metastatic and 103 nonmetastatic nodes. The SUVmax, SUVmean, SUVratio, TLG, COV and Dmin of metastatic lymph nodes were significantly higher/greater than those in nonmetastatic ones (P < 0.05). ROC curve analysis revealed that the combination of SUVratio, Dmin and COV showed the highest diagnostic efficacy among all single and combined parameters, the area under the curve (AUC) was 0.907 (P = 0.000), these three parameters all increased the risk of lymph node metastasis, with odds ratios of 1.848, 1.293 and 1.258, respectively (all P < 0.05). CONCLUSION Heterogeneity parameter was helpful for the accurate distinction of mediastinal lymph node metastasis in NSCLC. The combination of the SUVratio, Dmin and COV could improve the diagnostic accuracy. Multiple-parameters analysis plays an important complementary role in the diagnosis of lymph node metastasis.
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Affiliation(s)
- Jun Hua
- Department of Nuclear Medicine
| | - Lan Li
- Department of Radiology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, P.R. China
| | | | - Qi Liu
- Department of Nuclear Medicine
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9
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Porter JC, Win T, Erlandsson K, Fraioli F, Rashidnasab A, Holman B, Ganeshan B, Screaton NJ, Maher TM, Endozo R, Hoath J, Shortman RI, Emond E, Thielemans K, Hutton BF, Lukey PT, Aigbirhio F, Khan S, Rodriguez-Justo M, Groves AM. Measurement of hypoxia in the lung in IPF: an F-MISO PET CT study. Eur Respir J 2021; 58:13993003.04584-2020. [PMID: 34244317 DOI: 10.1183/13993003.04584-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/04/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Joanna C Porter
- CITR, UCL and Interstitial Lung Disease Centre, UCLH, London, UK.,Joint First Authors
| | - Thida Win
- Respiratory Medicine, Lister Hospital, Stevenage, UK.,Joint First Authors
| | | | | | | | | | | | | | - Toby M Maher
- Hastings Centre for Pulmonary Research and Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA.,Inflammation, Repair and Development Section, National Heart and Lung Institute, Imperial College, London, UK.,National Institute for Health Research (NIHR) Respiratory Biomedical Research Unit, Royal Brompton Hospital, London, UK
| | | | - John Hoath
- Institute of Nuclear Medicine, UCL/H, London, UK
| | | | - Elise Emond
- Institute of Nuclear Medicine, UCL/H, London, UK
| | | | | | - Pauline T Lukey
- Target to Treatment Consulting Ltd, Stevenage Bioscience Catalyst, Stevenage, UK
| | | | - Saif Khan
- Department of Histopathology, UCLH, London, UK
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10
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Florea A, Mottaghy FM, Bauwens M. Molecular Imaging of Angiogenesis in Oncology: Current Preclinical and Clinical Status. Int J Mol Sci 2021; 22:5544. [PMID: 34073992 PMCID: PMC8197399 DOI: 10.3390/ijms22115544] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/11/2022] Open
Abstract
Angiogenesis is an active process, regulating new vessel growth, and is crucial for the survival and growth of tumours next to other complex factors in the tumour microenvironment. We present possible molecular imaging approaches for tumour vascularisation and vitality, focusing on radiopharmaceuticals (tracers). Molecular imaging in general has become an integrated part of cancer therapy, by bringing relevant insights on tumour angiogenic status. After a structured PubMed search, the resulting publication list was screened for oncology related publications in animals and humans, disregarding any cardiovascular findings. The tracers identified can be subdivided into direct targeting of angiogenesis (i.e., vascular endothelial growth factor, laminin, and fibronectin) and indirect targeting (i.e., glucose metabolism, hypoxia, and matrix metallo-proteases, PSMA). Presenting pre-clinical and clinical data of most tracers proposed in the literature, the indirect targeting agents are not 1:1 correlated with angiogenesis factors but do have a strong prognostic power in a clinical setting, while direct targeting agents show most potential and specificity for assessing tumour vascularisation and vitality. Within the direct agents, the combination of multiple targeting tracers into one agent (multimers) seems most promising. This review demonstrates the present clinical applicability of indirect agents, but also the need for more extensive research in the field of direct targeting of angiogenesis in oncology. Although there is currently no direct tracer that can be singled out, the RGD tracer family seems to show the highest potential therefore we expect one of them to enter the clinical routine.
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Affiliation(s)
- Alexandru Florea
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (M.B.)
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (M.B.)
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229HX Maastricht, The Netherlands
| | - Matthias Bauwens
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (M.B.)
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229HX Maastricht, The Netherlands
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11
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Shi W, Fu Y, Wang Y. Downregulation of GLUT3 impairs STYK1/NOK-mediated metabolic reprogramming and proliferation in NIH-3T3 cells. Oncol Lett 2021; 22:527. [PMID: 34055092 PMCID: PMC8138895 DOI: 10.3892/ol.2021.12788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022] Open
Abstract
Serine threonine tyrosine kinase 1 (STYK1)/novel oncogene with kinase domain (NOK) has been demonstrated to promote cell carcinogenesis and tumorigenesis, as well as to strengthen cellular aerobic glycolysis, which is considered to be a defining hallmark of cancer. As the carriers of glucose into cells, glucose transporters (GLUTs) are important participants in cellular glucose metabolism and even tumorigenesis. However, to the best of our knowledge, the role of GLUTs in biological events caused by STYK1/NOK has not yet been reported. The present study assessed GLUT3 as a key transporter, and glucose consumption and lactate production assays revealed that downregulation of GLUT3 impaired STYK1/NOK-induced augmented glucose uptake and lactate production, and RT-qPCR and western blotting confirmed that GLUT3 knockdown attenuated the STYK1/NOK-induced increase in the expression levels of key enzymes implicated in glycolysis. Furthermore, MTT and Transwell assays demonstrated that STYK1/NOK-triggered cell proliferation and migration were also markedly decreased following knockdown of GLUT3. To the best of our knowledge, the present study is the first to demonstrate that GLUT3 serves a prominent role in STYK1/NOK-driven aerobic glycolysis and cell proliferation characteristics. These findings may provide a clue for the investigation of the oncogenic activity of STYK1/NOK and for the identification of potential tumor therapy targets associated with GLUT3.
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Affiliation(s)
- Weiye Shi
- Cell Engineering Laboratory, College of Biological Science and Engineering, Hebei University of Science and Technology, Shijiazhuang, Hebei 050018, P.R. China
| | - Yu Fu
- Cell Engineering Laboratory, College of Biological Science and Engineering, Hebei University of Science and Technology, Shijiazhuang, Hebei 050018, P.R. China
| | - Yingze Wang
- Cell Engineering Laboratory, College of Biological Science and Engineering, Hebei University of Science and Technology, Shijiazhuang, Hebei 050018, P.R. China
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12
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Majidpoor J, Mortezaee K. Angiogenesis as a hallmark of solid tumors - clinical perspectives. Cell Oncol (Dordr) 2021; 44:715-737. [PMID: 33835425 DOI: 10.1007/s13402-021-00602-3] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Angiogenesis is a key and early step in tumorigenesis, and is known as a hallmark of solid tumors and a key promoter of tumor recurrence. Unlike normal tissue vessels, the architecture of the tumor vasculature is abnormal, being leaky, tortuous, fragile and blind-ended. Perivascular cells are either detached or absent, causing reduction of vascular integrity, an increase in vessel immaturity, incoherent perfusion, defective functionality and enhanced tumor dissemination and metastasis. The abnormal tumor vasculature along with the defective tumor vessel functionality finally causes bouts of hypoxia and acidity in the tumor microenvironment (TME), further reinvigorating tumor aggression. Interstitial hypertension or high interstitial fluid pressure (IFP) is an outcome of tumor hyper-permeability. High IFP can be a barrier for either effective delivery of anti-cancer drugs toward the TME or accumulation of drugs within the tumor area, thus promoting tumor resistance to therapy. Some tumors do, however, not undergo angiogenesis but instead undergo vessel co-option or vascular mimicry, thereby adding another layer of complexity to cancer development and therapy. CONCLUSIONS Combination of anti-angiogenesis therapy with chemotherapy and particularly with immune checkpoint inhibitors (ICIs) is a promising strategy for a number of advanced cancers. Among the various approaches for targeting tumor angiogenesis, vascular normalization is considered as the most desired method, which allows effective penetration of chemotherapeutics into the tumor area, thus being an appropriate adjuvant to other cancer modalities.
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Affiliation(s)
- Jamal Majidpoor
- Department of Anatomy, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Keywan Mortezaee
- Cancer and Immunology Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Department of Anatomy, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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13
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Surov A, Wienke A. Associations Between FDG PET and Expression of VEGF and Microvessel Density in Different Solid Tumors: A Meta-analysis. Acad Radiol 2021; 28:e110-e117. [PMID: 32327296 DOI: 10.1016/j.acra.2020.02.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/29/2020] [Accepted: 02/29/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND To date, there are inconsistent data about relationships between 2-deoxy-2 [18F] fluoro-D-glucose positron emission tomography (FDG-PET) and expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD). The aim of the present meta-analysis was to systematize the reported data about associations between maximal standardized uptake value (SUVmax) derived from FDG PET and expression of VEGF and as well as MVD. METHODS MEDLINE library, SCOPUS and EMBASE data bases were screened for relationships between SUVmax and VEGF/MVD up to October 2019. Overall, in 18 studies correlations between SUVmax and VEGF and in 13 studies correlations between SUVmax and MVD were reported. The following data were extracted from the literature: authors, year of publication, number of patients, and correlation coefficients. RESULTS Associations between 18F-FDG PET and VEGF were reported in 18 studies (935 patients). The calculated correlation coefficients between SUVmax and VEGF expression ranged from -0.16 to 0.88. The pooled correlation coefficient was 0.32, (95% confidence interval [CI] = [0.15; 0.48]). Associations between 18F-FDG PET and MVD were investigated in 13 studies (593 patients). The reported correlation coefficients ranged from -0.23 to 0.91. The pooled correlation coefficient was 0.27, (95% CI = [0.00; 0.53]). Analysis of MVD based on CD105 immunohistochemical staining was performed in four studies (117 patients). The pooled correlation coefficient was 0.41 (95% CI = [0.22; 0.59]). In three reports with 233 patients, MVD was estimated by staining with CD31 antibody. The pooled correlation coefficient was 0.01, (95% CI = [-0.44; 0.47]). Finally, in 9 studies (280 patients) MVD was performed on CD34 stained specimens. The pooled correlation coefficient was 0.36, (95% CI = [0.09; 0.63]). CONCLUSION SUVmax of FDG PET correlated weakly with expression of VEGF and with MVD. Therefore, FDG PET cannot predict neoangiogenesis in malignant tumors.
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Affiliation(s)
- Alexey Surov
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany.
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Germany
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Liu S, Wu F, Zhang Y, Qin R, Zhu N, Li Y, Wang M, Zeng Q, Xie D, Li Y, Fan J, Han Y. Apatinib Combined With Radiotherapy Enhances Antitumor Effects in an In Vivo Nasopharyngeal Carcinoma Model. Cancer Control 2020; 27:1073274820922553. [PMID: 32420748 PMCID: PMC7235534 DOI: 10.1177/1073274820922553] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) are highly expressed in nasopharyngeal carcinoma; therefore, blocking the binding of VEGF and VEGFR may be a potential way to treat nasopharyngeal carcinoma. Apatinib inhibits tumor angiogenesis. Previous studies have suggested that treatment with apatinib has an antitumor effect on nasopharyngeal carcinoma. This study will investigate the effect of apatinib combined with radiotherapy. In this study, nude mice injected with CNE-2 nasopharyngeal carcinoma cells were randomly divided into 6 groups. Therapeutic effects were assessed by evaluating tumor inhibition rate, phosphorylation of VEGFR-2, CD31, partial oxygen pressure, and tumor metabolism. We found that the tumor inhibition of mice in the treated groups was better compared to that of the control group. In mice treated with apatinib alone, angiogenesis was prevented, and the tumor tissue partial oxygen pressure was reduced, thereby achieving an antitumor effect. Moreover, the tumor inhibitory effect of combined treatment was stronger than treatment with either apatinib or radiotherapy alone. Compared with monotherapy treatment, combined treatment better resisted angiogenesis. Apatinib combined with radiotherapy to treat nasopharyngeal carcinoma has synergistic effects, which may be related to enhanced antiangiogenesis.
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Affiliation(s)
- Shanshan Liu
- Department of General Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fei Wu
- Department of Thyroid Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yanling Zhang
- Department of Health Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Rongsheng Qin
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Nengping Zhu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yuan Li
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mingting Wang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qin Zeng
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Danna Xie
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yinghua Li
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Juan Fan
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yunwei Han
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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15
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Bădan MI, Bonci EA, Piciu D. A review on immunohistochemical and histopathologic validation in PET-CT findings with consideration to microRNAs. Med Pharm Rep 2019; 92:337-345. [PMID: 31750432 PMCID: PMC6853049 DOI: 10.15386/mpr-1341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 06/20/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose This review provides an overview of some of the most recent clinical trials which investigated various types of cancer and other diseases, through the use of PET-CT imaging, highlighting the use of immunohistochemical stains or conventional histopathology for the validation or contradiction of their hypothesis. Furthermore, we investigate a potential new direction of research by analyzing the upcoming role of microRNAs in disease confirmation. Methods An extensive search of MEDLINE/PubMed and SCOPUS electronic databases was made, using the MeSH terms "positron emission tomography computed tomography" and "immunohistochemistry" as well as "SUV" and "immunohistochemistry", restricting the search by clinical trials and time period. Further searches were made for articles regarding Ki-67 and microRNAs in correlation with metabolic PET-CT uptake. Results Out of all 389 initial search results, 27 original articles were found relevant to the topic. Their contents were synthesized and discussed regarding the matter at hand. No relevant clinical trials involving microRNAs were found. Conclusions Immunohistochemical and histopathologic results remain widely used and indispensable in modern research, concerning PET-CT validation. Possible candidates for diagnosis confirmation, in future research, may reside in the further development of microRNAs.
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Affiliation(s)
- Marius-Ioan Bădan
- Department of Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Eduard-Alexandru Bonci
- Department of Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Doina Piciu
- Department of Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Endocrinology and Nuclear Medicine, "Prof. Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
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Evidence of Prostate-Specific Membrane Antigen Expression in Hepatocellular Carcinoma Using 68Ga-PSMA PET/CT. Clin Nucl Med 2019; 44:702-706. [PMID: 31348076 DOI: 10.1097/rlu.0000000000002701] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Prostate specific membrane antigen (PSMA) expression has been demonstrated in tumor neovasculature of many solid tumors, including hepatocellular carcinoma (HCC). The purpose of this study is to evaluate PSMA expression in patients with HCC. MATERIALS AND METHODS Nineteen HCC patients who underwent F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) as part of restaging procedure also underwent Ga-PSMA PET. F-FDG PET and Ga-PSMA findings were compared visually as well as quantitatively using maximized standardized uptake values (SUVmax). RESULTS FDG was positive in 15 patients while 16 patients demonstrated PSMA expression. The only extrahepatic finding was one metastatic lymph node detected by both tracers. Mean SUVmax of liver lesions on FDG PET/CT was 8.3 ± 2.3 and mean tumor to background ratio was 2.3 ± 1.5. Respective values for Ga-PSMA PET/CT were 17.4 ± 9 and 3.3 ± 2.2. On visual and quantitative evaluation uptake was higher with PSMA in nine patients and higher with FDG in four patients. PSMA and FDG activity were similar in three patients. One of the FDG positive patients was PSMA negative whereas two patients were PSMA positive but FDG negative. Heterogeneous uptake pattern was observed in three patients. Comparison of mean SUVmax and T/B values between PET studies revealed no statistically significant difference (P > 0.1). The mean survival was 25 months (range: 18-32 months) and SUVmax of PSMA (P = 0.05) and FDG (P = 0.012) showed medium strength of correlation with overall survival. CONCLUSION PSMA expression in advanced HCC can be demonstrated by Ga-PSMA PET but is not superior to FDG PET however it could be useful for identifying patients with limited therapeutic options.
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Hong CM, Park SH, Chong GO, Lee YH, Jeong JH, Lee SW, Lee J, Ahn BC, Jeong SY. Enhancing prognosis prediction using pre-treatment nodal SUVmax and HPV status in cervical squamous cell carcinoma. Cancer Imaging 2019; 19:43. [PMID: 31234933 PMCID: PMC6591806 DOI: 10.1186/s40644-019-0226-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/13/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study was to evaluate the prognostic value of metabolic parameters on F-18-FDG PET/CT and the status of human papillomavirus (HPV) infection and known prognostic variables for predicting tumor recurrence and investigating a prognostic model in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy (CCRT). METHODS A total of 129 patients with cervical squamous cell carcinoma who underwent initial CCRT were eligible for this study. Univariate and multivariate analyses were performed using traditional prognostic factors, metabolic parameters, and HPV infection. Classification and regression decision tree (CART) was used to establish new classification. RESULTS Among 129 patients, 29 patients (22.5%) had recurrence after a median follow-up of 60 months (range, 3-125 months). Tumor size, para-aortic lymph node metastasis, nodal SUVmax, and HPV infection status were identified as independent prognostic factors by multivariate analysis. The CART analysis classified the patients into three groups. The first node was nodal SUVmax, and HPV status was the second node for patients with nodal SUVmax ≤7.49; Group A (nodal SUVmax ≤7.49 and HPV positive, HR 1.0), Group B (nodal SUVmax ≤7.49 and HPV negative, HR 3.56), and Group C (nodal SUVmax > 7.49, HR 10.13). Disease-free survival was significantly different among the three groups (p < 0.001). CONCLUSION The nodal SUVmax on F-18 FDG PET/CT and HPV infection status before CCRT are powerful independent prognostic factors for the prediction of disease-free survival in patients with cervical squamous cell carcinoma who underwent initial CCRT. We also suggest a simple prognosis prediction model using pre-treatment FDG PET/CT and HPV genotyping; however, it needs further validation in an independent dataset.
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Affiliation(s)
- Chae Moon Hong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin-Hyung Park
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Gun Oh Chong
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. .,Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.
| | - Yoon Hee Lee
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Ju Hye Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Nuclear Medicine, School of Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Nuclear Medicine, School of Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Jaetae Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. .,Department of Nuclear Medicine, School of Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.
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18
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Surov A, Meyer HJ, Höhn AK, Wienke A, Sabri O, Purz S. 18F-FDG-PET Can Predict Microvessel Density in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2019; 11:cancers11040543. [PMID: 30991696 PMCID: PMC6521262 DOI: 10.3390/cancers11040543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 12/19/2022] Open
Abstract
Aim: Positron emission tomography (PET) with 18F-fluordeoxyglucose (18F-FDG) plays an essential role in the staging and tumor monitoring of head and neck squamous cell carcinoma (HNSCC). Microvessel density (MVD) is one of the clinically important histopathological features in HNSCC. The purpose of this study was to analyze possible associations between 18F-FDG-PET findings and MVD parameters in HNSCC. Materials and Methods: Overall, 22 patients with a mean age of 55.2 ± 11.0 and with different HNSCC were acquired. In all cases, whole-body 18F-FDG-PET was performed. For each tumor, the maximum and mean standardized uptake values (SUVmax; SUVmean) were determined. The MVD, including stained vessel area and total number of vessels, was estimated on CD105 stained specimens. All specimens were digitalized and analyzed by using ImageJ software 1.48v. Spearman's correlation coefficient (r) was used to analyze associations between investigated parameters. p-values of <0.05 were taken to indicate statistical significance. Results: SUVmax correlated with vessel area (r = 0.532, p = 0.011) and vessel count (r = 0.434, p = 0.043). Receiver operating characteristic analysis identified a threshold SUVmax of 15 to predict tumors with high MVD with a sensitivity of 72.7% and specificity of 81.8%, with an area under the curve of 82.6%. Conclusion: ⁸F-FDG-PET parameters correlate statistically significantly with MVD in HNSCC. SUVmax may be used for discrimination of tumors with high tumor-related MVD.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
| | - Anne-Kathrin Höhn
- Department of Pathology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle, Germany.
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstrasse 18, 04103 Leipzig, Germany.
| | - Sandra Purz
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstrasse 18, 04103 Leipzig, Germany.
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19
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Song YS, Kim JH, Lee BC, Jung JH, Park HS, Kim SE. Biodistribution and Internal Radiation Dosimetry of 99mTc-IDA-D-[c(RGDfK)] 2 (BIK-505), a Novel SPECT Radiotracer for the Imaging of Integrin α vβ 3 Expression. Cancer Biother Radiopharm 2018; 33:396-402. [PMID: 30133309 PMCID: PMC6241326 DOI: 10.1089/cbr.2018.2505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Integrin αvβ3 is a molecular marker for the estimation of tumor angiogenesis. 99mTc-IDA-D-[c(RGDfK)]2 (also known as BIK-505) is a recently developed radiotracer for single-photon emission computed tomography, with good affinity for integrin αvβ3. In this study, the authors investigated the whole-body distribution and internal radiation dosimetry of 99mTc-IDA-D-[c(RGDfK)]2 in elderly human participants. Materials and Methods: Six healthy volunteers underwent whole-body simultaneous anterior and posterior scans, preceded by transmission scans using cobalt-57 flood source, with a dual head gamma camera system, at 0, 1, 2, 4, 8, and 24 h postinjection of 99mTc-IDA-D-[c(RGDfK)]2 (injected radioactivity [mean ± SD] = 388.7 ± 29.3 MBq). Anterior and posterior images were geometrically averaged and attenuation corrected to delineate the regions of interest in the liver, gallbladder, kidneys, urinary bladder, spleen, brain, and large intestine. Radiation dose for each organ and the effective doses (EDs) were estimated using OLINDA/EXM 1.1 software. Results: High radiation doses of renal and biliary excretion tracks such as the urinary bladder wall, upper large intestine, kidneys, liver, and gallbladder wall (19.15 ± 6.84, 19.28 ± 4.78, 15.67 ± 0.90, 9.13 ± 1.71, and 9.09 ± 2.03 μGy/MBq, respectively) were observed. The ED and effective dose equivalent were 5.08 ± 0.53 and 7.11 ± 0.58 μSv/MBq, respectively. Conclusions: Dosimetry results were comparable to other radiolabeled peptides and were considered safe and efficient for clinical usage.
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Affiliation(s)
- Yoo Sung Song
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, Republic of Korea
| | - Joong Hyun Kim
- 2 Division of Chemical and Medical Metrology, Center for Ionizing Radiation, Korea Research Institute of Standards and Science , Daejeon, Republic of Korea
| | - Byung Chul Lee
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, Republic of Korea.,3 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea
| | - Jae Ho Jung
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, Republic of Korea
| | - Hyun Soo Park
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, Republic of Korea.,4 Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University , Seoul, Republic of Korea
| | - Sang Eun Kim
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, Republic of Korea.,3 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea.,4 Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University , Seoul, Republic of Korea
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20
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Song YS, Park HS, Lee BC, Jung JH, Lee HY, Kim SE. Imaging of Integrin α vβ 3 Expression in Lung Cancers and Brain Tumors Using Single-Photon Emission Computed Tomography with a Novel Radiotracer 99mTc-IDA-D-[c(RGDfK)] 2. Cancer Biother Radiopharm 2018; 32:288-296. [PMID: 29053416 PMCID: PMC5661893 DOI: 10.1089/cbr.2017.2233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Integrin αvβ3 is a molecular marker for the estimation of tumor angiogenesis and is an imaging target for radiolabeled Arg-Gly-Asp (RGD) peptides. In this study, the authors investigated the clinical efficacy and safety of a novel radiolabeled RGD peptide, 99mTc-IDA-D-[c(RGDfK)]2, for the imaging of integrin αvβ3 expression, as a measure of tumor angiogenesis in lung cancers and brain tumors. Five patients with lung cancers and seven with brain tumors underwent 99mTc-IDA-D-[c(RGDfK)]2 single-photon emission computed tomography (SPECT) imaging. Tumors were also assessed using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Uptake of the radiotracer was expressed as the tumor-to-normal uptake ratio (TNR). All the lung cancers and brain tumors were well visualized on 99mTc-IDA-D-[c(RGDfK)]2 SPECT. TNR for 99mTc-IDA-D-[c(RGDfK)]2 was significantly higher than that for 18F-FDG in brain tumors (6.4 ± 4.1 vs. 0.9 ± 0.4). Proliferation index of brain tumors showed a significant positive correlation with TNR for 99mTc-IDA-D-[c(RGDfK)]2 and 18F-FDG. No laboratory and clinical adverse events were reported after 99mTc-IDA-D-[c(RGDfK)]2 injection. Their results suggest that 99mTc-IDA-D-[c(RGDfK)]2 is an efficacious and safe radiotracer for imaging integrin αvβ3 expression with potential application to monitoring the clinical efficacy of antiangiogenic agents in malignant tumors. In addition, this is the first clinical application of radiolabeled RGD peptides for SPECT imaging of brain tumors.
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Affiliation(s)
- Yoo Sung Song
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea
| | - Hyun Soo Park
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea.,2 Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University , Seoul, Republic of Korea
| | - Byung Chul Lee
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea.,3 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea
| | - Jae Ho Jung
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea
| | - Ho-Young Lee
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea
| | - Sang Eun Kim
- 1 Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea.,2 Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University , Seoul, Republic of Korea.,3 Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology , Suwon, Republic of Korea
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21
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Niccoli Asabella A, Di Palo A, Altini C, Ferrari C, Rubini G. Multimodality Imaging in Tumor Angiogenesis: Present Status and Perspectives. Int J Mol Sci 2017; 18:ijms18091864. [PMID: 28846661 PMCID: PMC5618513 DOI: 10.3390/ijms18091864] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/19/2017] [Accepted: 08/22/2017] [Indexed: 01/22/2023] Open
Abstract
Angiogenesis is a complex biological process that plays a central role in progression of tumor growth and metastasis. It led to a search for antiangiogenic molecules, and to design antiangiogenic strategies for cancer treatment. Noninvasive molecular imaging, such as positron emission tomography (PET) and single photon emission computed tomography (SPECT), could be useful for lesion detection, to select patients likely to respond to antiangiogenic therapies, to confirm successful targeting, and dose optimization. Additionally, nuclear imaging techniques could also aid in the development of new angiogenesis-targeted drugs and their validation. Angiogenesis imaging can be categorized as targeted at three major cell types: (I) non-endothelial cell targets, (II) endothelial cell targets, and (III) extracellular matrix proteins and matrix proteases. Even if radiopharmaceuticals studying the metabolism and hypoxia can be also used for the study of angiogenesis, many of the agents used in nuclear imaging for this purpose are yet to be investigated. The purpose of this review is to describe the role of molecular imaging in tumor angiogenesis, highlighting the advances in this field.
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Affiliation(s)
- Artor Niccoli Asabella
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Alessandra Di Palo
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Corinna Altini
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Cristina Ferrari
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Giuseppe Rubini
- Nuclear Medicine Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
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22
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Ganeshan B, Miles KA, Babikir S, Shortman R, Afaq A, Ardeshna KM, Groves AM, Kayani I. CT-based texture analysis potentially provides prognostic information complementary to interim fdg-pet for patients with hodgkin's and aggressive non-hodgkin's lymphomas. Eur Radiol 2017; 27:1012-1020. [PMID: 27380902 PMCID: PMC5306313 DOI: 10.1007/s00330-016-4470-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/03/2016] [Accepted: 06/07/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the ability of computed tomography texture analysis (CTTA) to provide additional prognostic information in patients with Hodgkin's lymphoma (HL) and high-grade non-Hodgkin's lymphoma (NHL). METHODS This retrospective, pilot-study approved by the IRB comprised 45 lymphoma patients undergoing routine 18F-FDG-PET-CT. Progression-free survival (PFS) was determined from clinical follow-up (mean-duration: 40 months; range: 10-62 months). Non-contrast-enhanced low-dose CT images were submitted to CTTA comprising image filtration to highlight features of different sizes followed by histogram-analysis using kurtosis. Prognostic value of CTTA was compared to PET FDG-uptake value, tumour-stage, tumour-bulk, lymphoma-type, treatment-regime, and interim FDG-PET (iPET) status using Kaplan-Meier analysis. Cox regression analysis determined the independence of significantly prognostic imaging and clinical features. RESULTS A total of 27 patients had aggressive NHL and 18 had HL. Mean PFS was 48.5 months. There was no significant difference in pre-treatment CTTA between the lymphoma sub-types. Kaplan-Meier analysis found pre-treatment CTTA (medium feature scale, p=0.010) and iPET status (p<0.001) to be significant predictors of PFS. Cox analysis revealed that an interaction between pre-treatment CTTA and iPET status was the only independent predictor of PFS (HR: 25.5, 95% CI: 5.4-120, p<0.001). Specifically, pre-treatment CTTA risk stratified patients with negative iPET. CONCLUSION CTTA can potentially provide prognostic information complementary to iPET for patients with HL and aggressive NHL. KEY POINTS • CT texture-analysis (CTTA) provides prognostic information complementary to interim FDG-PET in Lymphoma. • Pre-treatment CTTA and interim PET status were significant predictors of progression-free survival. • Patients with negative interim PET could be further stratified by pre-treatment CTTA. • Provide precision surveillance where additional imaging reserved for patients at greatest recurrence-risk. • Assists in risk-adapted treatment strategy based on interim PET and CTTA.
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Affiliation(s)
- B Ganeshan
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK.
| | - K A Miles
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - S Babikir
- Human Health Division, Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency (IAEA), Vienna, Austria
| | - R Shortman
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - A Afaq
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - K M Ardeshna
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - A M Groves
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - I Kayani
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
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23
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Wellberg EA, Johnson S, Finlay-Schultz J, Lewis AS, Terrell KL, Sartorius CA, Abel ED, Muller WJ, Anderson SM. The glucose transporter GLUT1 is required for ErbB2-induced mammary tumorigenesis. Breast Cancer Res 2016; 18:131. [PMID: 27998284 PMCID: PMC5168867 DOI: 10.1186/s13058-016-0795-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/25/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Altered tumor cell metabolism is an emerging hallmark of cancer; however, the precise role for glucose in tumor initiation is not known. GLUT1 (SLC2A1) is expressed in breast cancer cells and is likely responsible for avid glucose uptake observed in established tumors. We have shown that GLUT1 was necessary for xenograft tumor formation from primary mammary cells transformed with the polyomavirus middle-T antigen but that it was not necessary for growth after tumors had formed in vivo, suggesting a differential requirement for glucose depending on the stage of tumorigenesis. METHODS To determine whether GLUT1 is required early during mammary tumorigenesis, we crossed MMTV-NIC mice, which express activated HER2/NEU/ERBB2 and Cre recombinase, to Slc2a1 Flox/Flox (GLUT1Flox/Flox) mice to generate NIC-GLUT1+/+, NIC-GLUT1Flox/+, and NIC-GLUT1Flox/Flox mice. In addition, we evaluated effects of glucose restriction or GLUT1 inhibition on transformation in MCF10A-ERBB2 breast epithelial cells in three-dimensional culture. Finally, we utilized global gene expression profiling data of primary human breast tumors to determine the relationship between SLC2A1 and stage of tumorigenesis. RESULTS All of the NIC-GLUT1+/+ mice developed tumors in less than 200 days. In contrast, only 1 NIC-GLUT1Flox/Flox mouse and 1 NIC-GLUT1Flox/+ mouse developed mammary tumors, even after 18 months. Mammary gland development was not disrupted in NIC mice lacking GLUT1; however, epithelial content of mature glands was reduced compared to NIC-GLUT1Flox/+ mice. In MCF10A-ERBB2 cells, glucose restriction or GLUT1 inhibition blocked transformation induced by activated ERBB2 through reduced cell proliferation. In human breast cancers, SLC2A1 was higher in ductal carcinoma in situ compared to the normal breast, but lower in invasive versus in situ lesions, suggesting the requirement for GLUT1 decreases as tumors progress. CONCLUSIONS This study demonstrates a strict requirement for GLUT1 in the early stages of mammary tumorigenesis in vitro and in vivo. While metabolic adaptation has emerged as a hallmark of cancer, our data indicate that early tumor cells rely heavily on glucose and highlight the potential for glucose restriction as a breast cancer preventive strategy.
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Affiliation(s)
- Elizabeth A Wellberg
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA.
| | - Stevi Johnson
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA
| | - Jessica Finlay-Schultz
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA
| | - Andrew S Lewis
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA
| | - Kristina L Terrell
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA
| | - Carol A Sartorius
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA.,Program in Cancer Biology, MS 8401, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - E Dale Abel
- Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - William J Muller
- Department of Biochemistry, McGill University, Montreal, Quebec, H3A 1A3, Canada.,Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, Quebec, H3A 1A3, Canada
| | - Steven M Anderson
- Department of Pathology, MS 8401, University of Colorado Anschutz Medical Campus, 12801 East 17th Avenue, Box 8104, Aurora, CO, 80045, USA. .,Program in Cancer Biology, MS 8401, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA. .,Program in Molecular Biology, MS 8401, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
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24
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Sathekge M, Lengana T, Modiselle M, Vorster M, Zeevaart J, Maes A, Ebenhan T, Van de Wiele C. 68Ga-PSMA-HBED-CC PET imaging in breast carcinoma patients. Eur J Nucl Med Mol Imaging 2016; 44:689-694. [PMID: 27822700 PMCID: PMC5323468 DOI: 10.1007/s00259-016-3563-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/21/2016] [Indexed: 01/26/2023]
Abstract
Background To report on imaging findings using 68Ga-PSMA-HBED-CC PET in a series of 19 breast carcinoma patients. Methods 68Ga-PSMA-HBED-CC PET imaging results obtained were compared to routinely performed staging examinations and analyzed as to lesion location and progesterone receptor status. Results Out of 81 tumor lesions identified, 84% were identified on 68Ga-PSMA-HBED-CC PET. 68Ga-PSMA-HBED-CC SUVmean values of distant metastases proved significantly higher (mean, 6.86, SD, 5.68) when compared to those of primary or local recurrences (mean, 2.45, SD, 2.55, p = 0.04) or involved lymph nodes (mean, 3.18, SD, 1.79, p = 0.011). SUVmean values of progesterone receptor-positive lesions proved not significantly different from progesterone receptor-negative lesions. SUV values derived from FDG PET/CT, available in seven patients, and 68Ga-PSMA-HBED-CC PET/CT imaging proved weakly correlated (r = 0.407, p = 0.015). Conclusions 68Ga-PSMA-HBED-CC PET/CT imaging in breast carcinoma confirms the reported considerable variation of PSMA expression on human solid tumors using immunohistochemistry.
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Affiliation(s)
- Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.
| | - Thabo Lengana
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Moshe Modiselle
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - JanRijn Zeevaart
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Alex Maes
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium
| | - Thomas Ebenhan
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Christophe Van de Wiele
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Department of Radiology and Nuclear Medicine, University Ghent, Ghent, Belgium
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25
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Barron CC, Bilan PJ, Tsakiridis T, Tsiani E. Facilitative glucose transporters: Implications for cancer detection, prognosis and treatment. Metabolism 2016; 65:124-39. [PMID: 26773935 DOI: 10.1016/j.metabol.2015.10.007] [Citation(s) in RCA: 268] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/22/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022]
Abstract
It is long recognized that cancer cells display increased glucose uptake and metabolism. In a rate-limiting step for glucose metabolism, the glucose transporter (GLUT) proteins facilitate glucose uptake across the plasma membrane. Fourteen members of the GLUT protein family have been identified in humans. This review describes the major characteristics of each member of the GLUT family and highlights evidence of abnormal expression in tumors and cancer cells. The regulation of GLUTs by key proliferation and pro-survival pathways including the phosphatidylinositol 3-kinase (PI3K)-Akt, hypoxia-inducible factor-1 (HIF-1), Ras, c-Myc and p53 pathways is discussed. The clinical utility of GLUT expression in cancer has been recognized and evidence regarding the use of GLUTs as prognostic or predictive biomarkers is presented. GLUTs represent attractive targets for cancer therapy and this review summarizes recent studies in which GLUT1, GLUT3, GLUT5 and others are inhibited to decrease cancer growth.
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Affiliation(s)
- Carly C Barron
- Department of Health Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Philip J Bilan
- Program in Cell Biology, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Theodoros Tsakiridis
- Department of Oncology, and Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Evangelia Tsiani
- Department of Health Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada.
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Jo JE, Kim JY, Lee SH, Kim S, Kang T. Preoperative 18F-FDG PET/CT predicts disease-free survival in patients with primary invasive ductal breast cancer. Acta Radiol 2015; 56:1463-70. [PMID: 25406431 DOI: 10.1177/0284185114556929] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 09/29/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previous studies have correlated the maximum standardized uptake value (SUVmax) of breast cancer lesions with histological and biological characteristics such as tumor size, histologic grade, or hormonal receptor expression status. However, controversy remains concerning the prognostic value of SUVmax in breast cancer. PURPOSE To determine if the SUVmax of a tumor on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is associated with disease-free survival in patients with primary invasive ductal breast cancer. MATERIAL AND METHODS The institutional review board of our hospital approved this retrospective study. From 2009 to 2011, 508 women (mean age, 53.6 years; age range, 26-85 years) with newly diagnosed invasive ductal breast cancer who had undergone preoperative 18F-FDG PET/CT followed by surgery were identified. Clinicopathological variables and FDG uptake quantified by SUVmax were analyzed. The Cox proportional hazards model was used to evaluate the association between SUVmax and disease-free survival after controlling for clinicopathological parameters. RESULTS There were 21 recurrences at a median follow-up of 46 months. The mean SUVmax of the primary tumor was significantly higher in patients with a recurrence than those who remained disease-free (9.5 ± 3.5 vs. 6.6 ± 4.2, P < 0.001). A receiver operating characteristic curve indicated that a SUVmax of 5.95 was the optimal cut-off value to predict disease-free survival. Multivariate analysis identified a high SUVmax (≥5.95) and high T stage as independent significant variables associated with worse disease-free survival. CONCLUSION A high primary tumor SUVmax on 18F-FDG PET/CT was an independent factor associated with worse disease-free survival in patients with primary invasive ductal breast cancer.
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Affiliation(s)
- Ji Eun Jo
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Jin You Kim
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Suck Hong Lee
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Suk Kim
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Taewoo Kang
- Busan Cancer Center, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
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Comparison of the Prognostic Value of F-18 Pet Metabolic Parameters of Primary Tumors and Regional Lymph Nodes in Patients with Locally Advanced Cervical Cancer Who Are Treated with Concurrent Chemoradiotherapy. PLoS One 2015; 10:e0137743. [PMID: 26368542 PMCID: PMC4569279 DOI: 10.1371/journal.pone.0137743] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/20/2015] [Indexed: 11/23/2022] Open
Abstract
Objective This study investigated the metabolic parameters of primary tumors and regional lymph nodes, as measured by pre-treatment F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) to compare the prognostic value for the prediction of tumor recurrence. This study also identified the most powerful parameter in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy. Methods Fifty-six patients who were diagnosed with cervical cancer with pelvic and/or paraaortic lymph node metastasis were enrolled in this study. Metabolic parameters including the maximum standardized uptake value (SUVmax), the metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors and lymph nodes were measured by pre-treatment F-18 FDG PET/CT. Univariate and multivariate analyses for disease-free survival (DFS) were performed using the clinical and metabolic parameters. Results The metabolic parameters of the primary tumors were not associated with DFS. However, DFS was significantly longer in patients with low values of nodal metabolic parameters than in those with high values of nodal metabolic parameters. A univariate analysis revealed that nodal metabolic parameters (SUVmax, MTV and TLG), paraaortic lymph node metastasis, and post-treatment response correlated significantly with DFS. Among these parameters, nodal SUVmax (hazard ratio [HR], 4.158; 95% confidence interval [CI], 1.1–22.7; p = 0.041) and post-treatment response (HR, 7.162; 95% CI, 1.5–11.3; p = 0.007) were found to be determinants of DFS according to a multivariate analysis. Only nodal SUVmax was an independent pre-treatment prognostic factor for DFS, and the optimal cutoff for nodal SUVmax to predict progression was 4.7. Conclusion Nodal SUVmax according to pre-treatment F-18 FDG PET/CT may be a prognostic biomarker for the prediction of disease recurrence in patients with locally advanced cervical cancer.
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Yokobori Y, Toyoda M, Sakakura K, Kaira K, Tsushima Y, Chikamatsu K. (18)F-FDG uptake on PET correlates with biological potential in early oral squamous cell carcinoma. Acta Otolaryngol 2015; 135:494-9. [PMID: 25739639 DOI: 10.3109/00016489.2014.969385] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The maximum standardized uptake value (SUVmax) of early oral squamous cell carcinoma (OSCC) may have a role as an imaging biomarker for assessment of malignant potential, including cell metabolism and angiogenesis. OBJECTIVE The usefulness of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been proven in various cancers, including OSCC. Moreover, in several carcinomas, the SUVmax of the tumor has been shown to correlate with the histological type, tumor stage, differentiation, and prognosis. Here, we investigated whether the SUVmax of early OSCC was associated with the biological features. METHODS Twenty-seven patients with newly diagnosed early OSCC who underwent preoperative FDG-PET and curative surgical resection were included in this study. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (GLUT1), L-type amino acid transporter 1 (LAT1), CD98, microvessels (CD34), cell proliferation marker (Ki-67), and cell cycle regulator (p53). The correlation between SUVmax and clinicopathological findings or the expression level of these molecules was analyzed. RESULTS SUVmax of primary OSCC was significantly higher in patients with T2 stage. Moreover, patients whose tumors showed vascular invasion had a tendency to show higher SUVmax. A significant correlation was observed between SUVmax and the expression of LAT1 or microvessel density.
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Kim SJ, Bae PK, Chung BH. Self-assembled levan nanoparticles for targeted breast cancer imaging. Chem Commun (Camb) 2015; 51:107-10. [DOI: 10.1039/c4cc07679f] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report on the targeted imaging of breast cancer using self-assembled levan nanoparticles.
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Affiliation(s)
- Sun-Jung Kim
- BioNanotechnology Research Center
- Korea Research Institute of Bioscience and Biotechnology (KRIBB)
- Daejeon 305-806
- Republic of Korea
| | - Pan Kee Bae
- BioNano Health Guard Research Center
- Daejeon 305-806
- Republic of Korea
| | - Bong Hyun Chung
- BioNanotechnology Research Center
- Korea Research Institute of Bioscience and Biotechnology (KRIBB)
- Daejeon 305-806
- Republic of Korea
- BioNano Health Guard Research Center
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Tumour 18 F-FDG Uptake on preoperative PET/CT may predict axillary lymph node metastasis in ER-positive/HER2-negative and HER2-positive breast cancer subtypes. Eur Radiol 2014; 25:1172-81. [PMID: 25298170 DOI: 10.1007/s00330-014-3452-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/05/2014] [Accepted: 09/23/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate the association between tumour FDG uptake on preoperative PET/CT and axillary lymph node metastasis (ALNM) according to breast cancer subtype. METHODS The records of 671 patients with invasive breast cancer who underwent (18) F-FDG PET/CT and surgery were reviewed. Using immunohistochemistry, tumours were divided into three subtypes: oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HER2-positive, and triple-negative. Tumour FDG uptake, expressed as maximum standardized uptake value (SUVmax), and clinicopathological variables were analysed. RESULTS ALNM was present in 187 of 461 ER-positive/HER2-negative, 54 of 97 HER2-positive, and 38 of 113 triple-negative tumours. On multivariate analysis, high tumour SUVmax (≥4.25) (P < 0.001), large tumour size (>2 cm) (P = 0.003) and presence of lymphovascular invasion (P < 0.001) were independent variables associated with ALNM. On subset analyses, tumour SUVmax maintained independent significance for predicting ALNM in ER-positive/HER2-negative (adjusted odds ratio: 3.277, P < 0.001) and HER2-positive tumours (adjusted odds ratio: 14.637, P = 0.004). No association was found for triple-negative tumours (P = 0.161). CONCLUSIONS Tumour SUVmax may be an independent prognostic factor for ALNM in patients with invasive breast cancer, especially in ER-positive/HER2-negative and HER2-positive subtypes, but not in those with triple-negative subtype. KEY POINTS • Tumour SUVmax could be an imaging biomarker for predicting ALNM • Tumour SUVmax predicting ALNM is effective in ER-positive/HER2-negative and HER2-positive subtypes • Tumour SUVmax predicting ALNM is inaccurate in triple-negative subtypes • Accurate prognostic prediction based on molecular subtype may facilitate individualized management.
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Complementary Role of Semiquantitative Analysis of Breast-Specific Gamma Imaging in the Diagnosis of Breast Cancer. AJR Am J Roentgenol 2014; 202:690-5. [DOI: 10.2214/ajr.13.11324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Burger IA, Vargas HA, Apte A, Beattie BJ, Humm JL, Gonen M, Larson SM, Ross Schmidtlein C. PET quantification with a histogram derived total activity metric: superior quantitative consistency compared to total lesion glycolysis with absolute or relative SUV thresholds in phantoms and lung cancer patients. Nucl Med Biol 2014; 41:410-8. [PMID: 24666719 DOI: 10.1016/j.nucmedbio.2014.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 02/13/2014] [Accepted: 02/20/2014] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The increasing use of molecular imaging probes as biomarkers in oncology emphasizes the need for robust and stable methods for quantifying tracer uptake in PET imaging. The primary motivation for this research was to find an accurate method to quantify the total tumor uptake. Therefore we developed a histogram-based method to calculate the background subtracted lesion (BSL) activity and validated BSL by comparing the quantitative consistency with the total lesion glycolysis (TLG) in phantom and patient studies. METHODS A thorax phantom and a PET-ACR quality assurance phantom were scanned with increasing FDG concentrations. Volumes of interest (VOIs) were placed over each chamber. TLG was calculated with a fixed threshold at SUV 2.5 (TLG2.5) and a relative threshold at 42% of SUVmax (TLG42%). The histogram for each VOI was built and BSL was calculated. Comparison with the total injected FDG activity (TIA) was performed using concordance correlation coefficients (CCC) and the slope (a). Fifty consecutive patients with FDG-avid lung tumors were selected under an IRB waiver. TLG42%, TLG2.5 and BSL were compared to the reference standard calculating CCC and the slope. RESULTS In both phantoms, the CCC for lesions with a TIA ≤50ml*SUV between TIA and BSL was higher and the slope closer to 1 (CCC=0.933, a=1.189), than for TLG42% (CCC=0.350, a=0.731) or TLG2.5 (CCC=0.761, a=0.727). In 50 lung lesions BSL had a slope closer to 1 compared to the reference activity than TLG42% (a=1.084 vs 0.618 - for high activity lesions) and also closer to 1 than TLG2.5 (a=1.117 vs 0.548 - for low activity lesions). CONCLUSION The histogram based BSL correlated better with TIA in both phantom studies than TLG2.5 or TLG42%. Also in lung tumors, the BSL activity is overall more accurate in quantifying the lesion activity compared to the two most commonly applied TLG quantification methods.
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Affiliation(s)
- Irene A Burger
- Department of Radiology and Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland.
| | - Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Aditya Apte
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Bradley J Beattie
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - John L Humm
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Mithat Gonen
- Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - C Ross Schmidtlein
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
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Ueda S, Nakamiya N, Matsuura K, Shigekawa T, Sano H, Hirokawa E, Shimada H, Suzuki H, Oda M, Yamashita Y, Kishino O, Kuji I, Osaki A, Saeki T. Optical imaging of tumor vascularity associated with proliferation and glucose metabolism in early breast cancer: clinical application of total hemoglobin measurements in the breast. BMC Cancer 2013; 13:514. [PMID: 24176197 PMCID: PMC3817816 DOI: 10.1186/1471-2407-13-514] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 10/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Near-infrared optical imaging targeting the intrinsic contrast of tissue hemoglobin has emerged as a promising approach for visualization of vascularity in cancer research. We evaluated the usefulness of diffuse optical spectroscopy using time-resolved spectroscopic (TRS) measurements for functional imaging of primary breast cancer. METHODS Fifty-five consecutive TNM stage I/II patients with histologically proven invasive ductal carcinoma and operable breast tumors (<5 cm) who underwent TRS measurements were enrolled. Thirty (54.5%) patients underwent 18F-fluoro-deoxy-glucose (FDG) positron emission tomography with measurement of maximum tumor uptake. TRS was used to obtain oxyhemoglobin, deoxyhemoglobin, and total hemoglobin (tHb) levels from the lesions, surrounding normal tissue, and contralateral normal tissue. Lesions with tHb levels 20% higher than those present in normal tissue were defined as "hotspots," while others were considered "uniform." The findings in either tumor type were compared with clinicopathological factors. RESULTS "Hotspot" tumors were significantly larger (P= 0.002) and exhibited significantly more advanced TNM stage (P=0.01), higher mitotic counts (P=0.01) and higher levels of FDG uptake (P=0.0004) compared with "uniform" tumors; however, other pathological variables were not significantly different between the two groups. CONCLUSIONS Optical imaging for determination of tHb levels allowed for measurement of tumor vascularity as a function of proliferation and glucose metabolism, which may be useful for prediction of patient prognosis and potential response to treatment.
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Affiliation(s)
- Shigeto Ueda
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Noriko Nakamiya
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Kazuo Matsuura
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Takashi Shigekawa
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Hiroshi Sano
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Eiko Hirokawa
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Hiroko Shimada
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Hiroaki Suzuki
- Central Research Laboratory, Hamamatsu Photonics K.K, Hamamatsu City 434-8601, Japan
| | - Motoki Oda
- Central Research Laboratory, Hamamatsu Photonics K.K, Hamamatsu City 434-8601, Japan
| | - Yutaka Yamashita
- Central Research Laboratory, Hamamatsu Photonics K.K, Hamamatsu City 434-8601, Japan
| | - Osamu Kishino
- Central US Service, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Akihiko Osaki
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka City 350-1298, Saitama, Japan
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Budiawan H, Cheon GJ, Im HJ, Lee SJ, Paeng JC, Kang KW, Chung JK, Lee DS. Heterogeneity Analysis of (18)F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting. Nucl Med Mol Imaging 2013; 47:232-41. [PMID: 24900118 DOI: 10.1007/s13139-013-0216-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 07/07/2013] [Accepted: 07/11/2013] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Lymph node (LN) characterization is crucial in determining the stage and treatment decisions in patient with lung cancer. Although (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has a higher diagnostic accuracy in LN characterization than anatomical imaging, differentiating between metastatic and inflammatory LNs is still challenging because both could show high (18)F-FDG uptake. The purpose of this study was to assess if the heterogeneity of the (18)F-FDG uptake could help in differentiating between inflammatory and metastatic LNs in lung cancer, and to compare with other parameters. METHODS A total of 44 patients with adenocarcinoma of the lung, who underwent preoperative (18)F-FDG PET/CT without having any previous treatments and were revealed to have (18)F-FDG-avid LNs, were enrolled. There were 52 pathology-proven metastatic lymph nodes in 26 subjects. The pathology-proven metastatic LNs were compared with 42 pathology-proven inflammatory/benign LNs in 18 subjects. The coefficient of variation (CV) was used to assess the heterogeneity of (18)F-FDG uptake by dividing the standard deviation of standardized uptake value (SUV) by mean SUV. The volume of interest was manually drawn based on the combined CT images of (18)F-FDG PET/CT (no threshold is used). Comparisons were made with the maximum standardized uptake values (SUVmax), visual assessment of (18)F-FDG uptake, longest diameter, and maximum Hounsfield units (HUmax). RESULTS Metastatic lymph nodes tended to have higher CVs than the inflammatory LNs. The mean CV of metastatic LNs (0.30 ± 0.08; range: 0.08-0.55) was higher than that of inflammatory LNs (0.17 + 0.06; range, 0.07-0.32; P < 0.0001). On receiver operating characteristic (ROC) curve analysis, the area under curve was 0.901, and using 0.20 as cut-off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 88.5 %, 76.2 %, 82.2 %, 84.3, and 83.0 % respectively. Accuracy of CV was slightly higher than SUVmax and diameter, but significantly higher than visual assessment and HUmax. CONCLUSIONS In patients with adenocarcinoma of the lung having no prior treatments, metastatic LNs showed more heterogeneous (18)F-FDG uptake than inflammatory LNs. Measuring the CV of the SUV derived from a manual volume of interest (VOI) can be helpful in determining metastatic LN of adenocarcinoma of the lung. Including diagnostic criteria of CV into the diagnostic approach can increase the accuracy of mediastinal node status.
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Affiliation(s)
- Hendra Budiawan
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Nuclear Medicine, Mochtar Riady Comprehensive Cancer Centre, Siloam Hospitals Semanggi, Jakarta, Indonesia
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea ; Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehangro, Jongro-gu, Seoul 110-744 Korea
| | - Hyung-Jun Im
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Soo Jin Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
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Bolouri MS, Elias SG, Wisner DJ, Behr SC, Hawkins RA, Suzuki SA, Banfield KS, Joe BN, Hylton NM. Triple-negative and non-triple-negative invasive breast cancer: association between MR and fluorine 18 fluorodeoxyglucose PET imaging. Radiology 2013; 269:354-61. [PMID: 23878283 DOI: 10.1148/radiol.13130058] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To assess the relationship between parameters measured on dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in primary invasive breast cancer. MATERIALS AND METHODS This HIPAA-compliant study was a retrospective review of medical records and therefore approved by the institutional review board without the requirement for informed consent. Patients with a diagnosis of invasive breast cancer from January 2005 through December 2009 who underwent both DCE MR imaging and FDG PET/CT before treatment initiation were retrospectively identified. Fractional volumes were measured for ranges of signal enhancement ratio (SER) values from DCE MR imaging data and compared with maximum standardized uptake values (SUVmax) from FDG PET/CT data. Linear regression analysis was performed to clarify the relationship between SER and SUVmax, adjusting for tumor size, pathologic grade, and receptor status. RESULTS Analyzed were 117 invasive breast cancers in 117 patients. Overall, a higher percentage of high washout kinetics was positively associated with SUVmax (1.57% increase in SUVmax per 1% increase in high washout; P = .020), and a higher percentage of low plateau kinetics was negatively associated with SUVmax (1.19% decrease in SUVmax per 1% increase in low plateau; P = .003). These relationships were strongest among triple-negative (TN) tumors (4.34% increase in SUVmax per 1% increase in high washout and 2.65% decrease in SUVmax per 1% increase in low plateau; P = .018 and .004, respectively). CONCLUSION In invasive breast carcinoma, there is a positive relationship between the percentage of high washout and SUVmax and a negative relationship between the percentage of low plateau and SUVmax. These results are stronger in TN tumors. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13130058/-/DC1.
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Affiliation(s)
- Marjan S Bolouri
- Departments of Radiology and Biomedical Imaging, University of California, San Francisco, 1600 Divisadero St, C250, San Francisco, CA 94115
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Win T, Miles KA, Janes SM, Ganeshan B, Shastry M, Endozo R, Meagher M, Shortman RI, Wan S, Kayani I, Ell PJ, Groves AM. Tumor heterogeneity and permeability as measured on the CT component of PET/CT predict survival in patients with non-small cell lung cancer. Clin Cancer Res 2013; 19:3591-9. [PMID: 23659970 DOI: 10.1158/1078-0432.ccr-12-1307] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE We prospectively examined the role of tumor textural heterogeneity on positron emission tomography/computed tomography (PET/CT) in predicting survival compared with other clinical and imaging parameters in patients with non-small cell lung cancer (NSCLC). EXPERIMENTAL DESIGN The feasibility study consisted of 56 assessed consecutive patients with NSCLC (32 males, 24 females; mean age 67 ± 9.7 years) who underwent combined fluorodeoxyglucose (FDG) PET/CT. The validation study population consisted of 66 prospectively recruited consecutive consenting patients with NSCLC (37 males, 29 females; mean age, 67.5 ± 7.8 years) who successfully underwent combined FDG PET/CT-dynamic contrast-enhanced (DCE) CT. Images were used to derive tumoral PET/CT textural heterogeneity, DCE CT permeability, and FDG uptake (SUVmax). The mean follow-up periods were 22.6 ± 13.3 months and 28.5± 13.2 months for the feasibility and validation studies, respectively. Optimum threshold was determined for clinical stage and each of the above biomarkers (where available) from the feasibility study population. Kaplan-Meier analysis was used to assess the ability of the biomarkers to predict survival in the validation study. Cox regression determined survival factor independence. RESULTS Univariate analysis revealed that tumor CT-derived heterogeneity (P < 0.001), PET-derived heterogeneity (P = 0.003), CT-derived permeability (P = 0.002), and stage (P < 0.001) were all significant survival predictors. The thresholds used in this study were derived from a previously conducted feasibility study. Tumor SUVmax did not predict survival. Using multivariable analysis, tumor CT textural heterogeneity (P = 0.021), stage (P = 0.001), and permeability (P < 0.001) were independent survival predictors. These predictors were independent of patient treatment. CONCLUSIONS Tumor stage and CT-derived textural heterogeneity were the best predictors of survival in NSCLC. The use of CT-derived textural heterogeneity should assist the management of many patients with NSCLC.
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Affiliation(s)
- Thida Win
- Lister Hospital, Coreys Mills Lane, Stevenage, Hertfordshire, United Kingdom
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Shastry M, Miles KA, Win T, Janes SM, Endozo R, Meagher M, Ell PJ, Groves AM. Integrated
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F-Fluorodeoxyglucose–Positron Emission Tomography/Dynamic Contrast-Enhanced Computed Tomography to Phenotype Non–Small Cell Lung Carcinoma. Mol Imaging 2012. [DOI: 10.2310/7290.2011.00052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Manu Shastry
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Kenneth A. Miles
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Thida Win
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Sam M. Janes
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Raymond Endozo
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Marie Meagher
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Peter J. Ell
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
| | - Ashley M. Groves
- From the Institute of Nuclear Medicine and Centre for Respiratory Research, University College London, London, UK; Brighton and Sussex University Hospitals, Brighton, UK; and Chest Medicine, Lister Hospital, Stevenage, Herts, UK
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Mansi L, Ciarmiello A, Cuccurullo V. PET/MRI and the revolution of the third eye. Eur J Nucl Med Mol Imaging 2012; 39:1519-24. [DOI: 10.1007/s00259-012-2185-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Diagnostic and prognostic correlates of preoperative FDG PET for breast cancer. Eur J Nucl Med Mol Imaging 2012; 39:1618-27. [PMID: 22777335 DOI: 10.1007/s00259-012-2181-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 06/21/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE To explore the preoperative utility of FDG PET for the diagnosis and prognosis in a retrospective breast cancer case series. METHODS In this retrospective study, 104 patients who had undergone a preoperative FDG PET scan for primary breast cancer at the UZ Brussel during the period 2002-2008 were identified. Selection criteria were: histological confirmation, FDG PET performed prior to therapy, and breast surgery integrated into the primary therapy plan. Patterns of increased metabolism were recorded according to the involved locations: breast, ipsilateral axillary region, internal mammary chain, or distant organs. The end-point for the survival analysis using Cox proportional hazards was disease-free survival. The contribution of prognostic factors was evaluated using the Akaike information criterion and the Nagelkerke index. RESULTS PET positivity was associated with age, gender, tumour location, tumour size >2 cm, lymphovascular invasion, oestrogen and progesterone receptor status. Among 63 patients with a negative axillary PET status, 56 (88.9 %) had three or fewer involved nodes, whereas among 41 patients with a positive axillary PET status, 25 (61.0 %) had more than three positive nodes (P < 0.0001). In the survival analysis of preoperative characteristics, PET axillary node positivity was the foremost statistically significant factor associated with decreased disease-free survival (hazard ratio 2.81, 95% CI 1.17-6.74). CONCLUSION Preoperative PET axillary node positivity identified patients with a higher burden of nodal involvement, which might be important for treatment decisions in breast cancer patients.
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Song BI, Lee SW, Jeong SY, Chae YS, Lee WK, Ahn BC, Lee J. 18F-FDG uptake by metastatic axillary lymph nodes on pretreatment PET/CT as a prognostic factor for recurrence in patients with invasive ductal breast cancer. J Nucl Med 2012; 53:1337-44. [PMID: 22870824 DOI: 10.2967/jnumed.111.098640] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED This study assessed the maximum standardized uptake value of metastatic axillary lymph nodes in patients with invasive ductal breast cancer (IDC) to determine the pretreatment prognostic value of (18)F-FDG PET/CT for disease-free survival (DFS). METHODS Sixty-five female IDC patients who had undergone pretreatment (18)F-FDG PET/CT and had pathologically confirmed axillary lymph node involvement without distant metastasis were enrolled. All patients showed complete remission after first-line treatment. To obtain nodal SUVmax, a transaxial image representing the highest (18)F-FDG uptake was carefully selected and a region of interest was manually drawn on the (18)F-FDG-accumulating lesion. Clinicopathologic parameters such as age, TNM stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, and primary-tumor and nodal SUVmax on PET were analyzed for their usefulness in predicting recurrence. Combinatorial effects and interactions between variables that were significant by univariate analysis were examined using multivariate Cox proportional-hazards models. RESULTS Twelve of 65 patients (18.5%) experienced recurrence during follow-up (median follow-up, 36 mo; range, 21-57 mo). Nodal SUVmax was significantly higher in patients with recurrence than in those who were disease-free (recurrence group: 5.2 ± 2.3, vs. disease-free group: 1.9 ± 1.9, P < 0.0001). A receiver-operating-characteristic curve demonstrated a nodal SUVmax of 2.8 (sensitivity, 91.7%; specificity, 86.8%; area under the curve, 0.890) to be the optimal cutoff for predicting DFS. Univariate analysis revealed that T stage, N stage, estrogen receptor status, and primary-tumor and nodal SUVmax correlated significantly with DFS. Among these 5 variables, only nodal SUVmax was found to be a single determinant of DFS by multivariate analysis (hazard ratio, 31.54; 95% confidence interval, 2.66-373.39; P = 0.0065). CONCLUSION Nodal SUVmax on pretreatment (18)F-FDG PET/CT may be an independent prognostic factor for disease recurrence in patients with IDC.
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Affiliation(s)
- Bong-Il Song
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea
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Groves AM, Shastry M, Ben-Haim S, Kayani I, Malhotra A, Davidson T, Kelleher T, Whittaker D, Meagher M, Holloway B, Warren RM, Ell PJ, Keshtgar MR. Defining the role of PET-CT in staging early breast cancer. Oncologist 2012; 17:613-9. [PMID: 22539550 DOI: 10.1634/theoncologist.2011-0270] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Currently, there is a lack of data on the role of combined positron emission tomography-computed tomography (PET-CT) in the staging of early invasive primary breast cancer. We therefore evaluated the role of (18)F-fluorodeoxyglucose ((18)F-FDG)-PET-CT in this patient population. METHODS We prospectively recruited 70 consecutive patients (69 women, one man; mean age, 61.9 ± 8.1 years) with early primary breast cancer for staging with (18)F-FDG-PET-CT. All PET-CT images were interpreted by two readers (independently of each other). A third reader adjudicated any discrepancies. All readers had ≥5 years of specific experience. Ethics board approval and informed consent were obtained. RESULTS The mean clinical follow-up was 22.7 ± 12.6 months. The primary tumor was identified with PET-CT in 64 of 70 patients. Of the unidentified lesions, surgical pathology revealed two intraductal carcinomas, one invasive tubular carcinoma, and three invasive lobular carcinomas. Undiagnosed multifocal breast disease was shown in seven of 70 patients. PET-CT identified avid axillary lymph nodes in 19 of 70 patients, compared with 24 of 70 confirmed during surgery. There were four patients who were axillary node positive on PET but had no axillary disease at surgery. Five patients were reported with avid metastases. Two of those patients were treated for metastatic disease (nodal, lung, and liver in one and bone metastases in the other) following further imaging and clinical assessment. In the other three patients, lesions (lung, n = 1; pleural, n = 1; paratrachael node, n = 1) were subsequently diagnosed as benign lesions. CONCLUSION Integrated (18)F-FDG-PET-CT may have a role in staging patients presenting with early breast cancer.
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Affiliation(s)
- Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, United Kingdom.
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Goh V, Rodriguez-Justo M, Engledow A, Shastry M, Endozo R, Peck J, Meagher M, Taylor SA, Halligan S, Groves AM. Assessment of the metabolic flow phenotype of primary colorectal cancer: correlations with microvessel density are influenced by the histological scoring method. Eur Radiol 2012; 22:1687-92. [PMID: 22527369 DOI: 10.1007/s00330-012-2423-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/16/2011] [Accepted: 01/05/2012] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To investigate how the histological scoring of microvessel density affects correlations between integrated (18)F-FDG-PET/perfusion CT parameters and CD105 microvessel density. METHODS A total of 53 patients were enrolled from 2007 to 2010. Integrated (18)F-FDG-PET/perfusion CT was successful in 45 patients, 35 of whom underwent surgery without intervening treatment. Tumour SUV(max), SUV(mean) and regional blood flow (BF) were derived. Immunohistochemical staining for CD105 expression and analysis were performed for two hot spots, four hot spots and the Chalkley method. Correlations between metabolic flow parameters and CD105 expression were assessed using Spearman's rank correlation. RESULTS Mean (SD) for tumour size was 38.5 (20.5) mm, for SUV(max), SUV(mean) and BF it was 19.1 (4.5), 11.6 (2.5) and 85.4 (40.3) mL/min/100 g tissue, and for CD105 microvessel density it was 71.4 (23.6), 66.8 (22.9) and 6.18 (2.07) for two hot spots, four hot spots and the Chalkley method, respectively. Positive correlation between BF and CD105 expression was modest but higher for Chalkley than for four hot spots analysis (r = 0.38, P = 0.03; r = 0.33, P = 0.05, respectively). There were no significant correlations between metabolic parameters (SUV(max) or SUV(mean)) and CD105 expression (r = 0.08-0.22, P = 0.21-0.63). CONCLUSIONS The histological analysis method affects correlations between tumour CD105 expression and BF but not SUV(max) or SUV(mean). KEY POINTS • FDG-PET/perfusion CT offers new surrogate biomarkers of angiogenesis. • Microvessel density scoring influences histopathological correlations with CT blood flow. • Highest correlations were found with the Chalkley analysis method. • Correlations between SUV and CD105 are not affected by the scoring method.
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Affiliation(s)
- Vicky Goh
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK,
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Cochet A, Pigeonnat S, Khoury B, Vrigneaud JM, Touzery C, Berriolo-Riedinger A, Dygai-Cochet I, Toubeau M, Humbert O, Coudert B, Fumoleau P, Arnould L, Brunotte F. Evaluation of breast tumor blood flow with dynamic first-pass 18F-FDG PET/CT: comparison with angiogenesis markers and prognostic factors. J Nucl Med 2012; 53:512-20. [PMID: 22343501 DOI: 10.2967/jnumed.111.096834] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The purpose of this study was to prospectively evaluate the relationship between tumor blood flow and glucose metabolism as evaluated by dynamic first-pass (18)F-FDG PET and by proliferation and endothelial pathologic markers in the setting of newly diagnosed breast cancer. METHODS Forty patients were prospectively included. Biopsy samples of each tumor were used to assess the Ki67 index of proliferation and immunostaining for CD34 (a panendothelial cell marker) and CD105 (a proliferation-related endothelial cell marker). All patients underwent (18)F-FDG PET/CT at least 1 wk after sample biopsy and before any treatment. A dynamic 2-min acquisition was performed immediately after intravenous injection of a 5 MBq/kg dose of (18)F-FDG; tumor blood flow was then calculated using a single-compartment kinetic model. A static acquisition was performed 90 min after injection for quantification of delayed (18)F-FDG tumor uptake (standardized uptake value maximal index [SUV(max)]), reflecting tumor metabolism. RESULTS Pathologic and PET/CT data were available for all patients. The SUV(max) measured on delayed PET images correlated strongly and positively with the expression of Ki67 (r = +0.69; P < 0.0001). In contrast, there was no significant correlation between SUV(max) and endothelial markers (CD34 and CD105). Tumor blood flow correlated positively with the expression of CD34 and CD105 (P = 0.016 and P = 0.007, respectively) and with the expression of Ki67 (P = 0.028). By logistic regression analysis, only expression of Ki67 remained an independent predictor of high (supramedian) SUV(max); CD105 score and histopathologic grade 3 were independently associated with a high (supramedian) tumor blood flow level. CONCLUSION Tumor blood flow quantified by dynamic first-pass (18)F-FDG PET/CT is significantly associated with tumor angiogenesis as evaluated by immunohistochemistry in the setting of breast cancer, whereas tumor metabolism appears to be more associated with markers of proliferation. Thus, determination of tumor blood flow and metabolism with a single injection of (18)F-FDG could be an exciting alternative to more complex and less available techniques.
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Affiliation(s)
- Alexandre Cochet
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France.
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Abstract
Much evidence now suggests that angiotensin II has roles in normal functions of the breast that may be altered or attenuated in cancer. Both angiotensin type 1 (AT1) and type 2 (AT2) receptors are present particularly in the secretory epithelium. Additionally, all the elements of a tissue renin-angiotensin system, angiotensinogen, prorenin and angiotensin-converting enzyme (ACE), are also present and distributed in different cell types in a manner suggesting a close relationship with sites of angiotensin II activity. These findings are consistent with the concept that stromal elements and myoepithelium are instrumental in maintaining normal epithelial structure and function. In disease, this system becomes disrupted, particularly in invasive carcinoma. Both AT1 and AT2 receptors are present in tumours and may be up-regulated in some. Experimentally, angiotensin II, acting via the AT1 receptor, increases tumour cell proliferation and angiogenesis, both these are inhibited by blocking its production or function. Epidemiological evidence on the effect of expression levels of ACE or the distribution of ACE or AT1 receptor variants in many types of cancer gives indirect support to these concepts. It is possible that there is a case for the therapeutic use of high doses of ACE inhibitors and AT1 receptor blockers in breast cancer, as there may be for AT2 receptor agonists, though this awaits full investigation. Attention is drawn to the possibility of blocking specific AT1-mediated intracellular signalling pathways, for example by AT1-directed antibodies, which exploit the possibility that the extracellular N-terminus of the AT1 receptor may have previously unsuspected signalling roles.
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Affiliation(s)
- Gavin P Vinson
- School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK.
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Current world literature. Curr Opin Oncol 2011; 23:700-9. [PMID: 21993416 DOI: 10.1097/cco.0b013e32834d384a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carvalho KC, Cunha IW, Rocha RM, Ayala FR, Cajaíba MM, Begnami MD, Vilela RS, Paiva GR, Andrade RG, Soares FA. GLUT1 expression in malignant tumors and its use as an immunodiagnostic marker. Clinics (Sao Paulo) 2011; 66:965-72. [PMID: 21808860 PMCID: PMC3129958 DOI: 10.1590/s1807-59322011000600008] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 02/28/2011] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To analyze glucose transporter 1 expression patterns in malignant tumors of various cell types and evaluate their diagnostic value by immunohistochemistry. INTRODUCTION Glucose is the major source of energy for cells, and glucose transporter 1 is the most common glucose transporter in humans. Glucose transporter 1 is aberrantly expressed in several tumor types. Studies have implicated glucose transporter 1 expression as a prognostic and diagnostic marker in tumors, primarily in conjunction with positron emission tomography scan data. METHODS Immunohistochemistry for glucose transporter 1 was performed in tissue microarray slides, comprising 1955 samples of malignant neoplasm from different cell types. RESULTS Sarcomas, lymphomas, melanomas and hepatoblastomas did not express glucose transporter 1. Forty-seven per cent of prostate adenocarcinomas were positive, as were 29% of thyroid, 10% of gastric and 5% of breast adenocarcinomas. Thirty-six per cent of squamous cell carcinomas of the head and neck were positive, as were 42% of uterine cervix squamous cell carcinomas. Glioblastomas and retinoblastomas showed membranous glucose transporter 1 staining in 18.6% and 9.4% of all cases, respectively. Squamous cell carcinomas displayed membranous expression, whereas adenocarcinomas showed cytoplasmic glucose transporter 1 expression. CONCLUSION Glucose transporter 1 showed variable expression in various tumor types. Its absence in sarcomas, melanomas, hepatoblastomas and lymphomas suggests that other glucose transporters mediate the glycolytic pathway in these tumors. The data suggest that glucose transporter 1 is a valuable immunohistochemical marker that can be used to identify patients for evaluation by positron emission tomography scan. The function of cytoplasmic glucose transporter 1 in adenocarcinomas must be further examined.
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Affiliation(s)
- Kátia C Carvalho
- Departament of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
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