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Al Tabaa Y, Bailly C, Kanoun S. FDG-PET/CT in Lymphoma: Where Do We Go Now? Cancers (Basel) 2021; 13:cancers13205222. [PMID: 34680370 PMCID: PMC8533807 DOI: 10.3390/cancers13205222] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 01/06/2023] Open
Abstract
18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is an essential part of the management of patients with lymphoma at staging and response evaluation. Efforts to standardize PET acquisition and reporting, including the 5-point Deauville scale, have enabled PET to become a surrogate for treatment success or failure in common lymphoma subtypes. This review summarizes the key clinical-trial evidence that supports PET-directed personalized approaches in lymphoma but also points out the potential place of innovative PET/CT metrics or new radiopharmaceuticals in the future.
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Affiliation(s)
- Yassine Al Tabaa
- Scintidoc Nuclear Medicine Center, 25 rue de Clémentville, 34070 Montpellier, France
- Correspondence:
| | - Clement Bailly
- CRCINA, INSERM, CNRS, Université d’Angers, Université de Nantes, 44093 Nantes, France;
- Nuclear Medicine Department, University Hospital, 44093 Nantes, France
| | - Salim Kanoun
- Nuclear Medicine Department, Institute Claudius Regaud, 31100 Toulouse, France;
- Cancer Research Center of Toulouse (CRCT), Team 9, INSERM UMR 1037, 31400 Toulouse, France
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Wang R, Xu B, Liu C, Guan Z, Zhang J, Li F, Sun L, Zhu H. Prognostic value of interim fluorodeoxyglucose and fluorothymidine PET/CT in diffuse large B-cell lymphoma. Br J Radiol 2018; 91:20180240. [PMID: 30004787 DOI: 10.1259/bjr.20180240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE: To examine the prognostic value of fluorodeoxyglucose (FDG) and fluorothymidine (FLT) interim positron emission tomography/CT (PET/CT) for diffuse large B-cell lymphoma (DLBCL). METHODS: 44 patients with newly diagnosed DLBCL underwent both fluorine 18 FDG (18F-FDG) and 18F-FLT PET/CT scans at baseline and after two cycles of a rituximab-containing chemotherapy regimen. Maximum standard uptake values (SUVmax) and changes in SUV (ΔSUV) were calculated for both tracers for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS). RESULTS: The median follow-up period was 71 months. Receiver operating characteristic (ROC) analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) and FLT (ΔSUVFLT) were 79 and 76%, respectively. A ΔSUVFLT cut-off of 76% had the highest significance for prediction of PFS (p = 0.003) and OS (p = 0009), with sensitivity, specificity, and accuracy of 80.0, 85.7, and 81.8% respectively in response assessment. CONCLUSION: Interim FLT PET/CT had higher specificity and accuracy than standard FDG PET/CT-based interpretation. ADVANCES IN KNOWLEDGE: This study demonstrated that interim FLT PET/CT had higher accuracy than standardized FDG-based interpretation for therapeutic response assessment in DLBCL. FLT had the advantage of potentially reducing false positive of interim FDG PET/CT.
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Affiliation(s)
- Ruimin Wang
- 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China
| | - Baixuan Xu
- 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China
| | - Changbin Liu
- 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China
| | - Zhiwei Guan
- 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China
| | - Jinming Zhang
- 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China
| | - Fei Li
- 2 Department of Hematology, PLA General Hospital , Beijing , China
| | - Lu Sun
- 3 Department of Pathology, PLA General Hospital , Beijing , China
| | - Haiyan Zhu
- 2 Department of Hematology, PLA General Hospital , Beijing , China
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Nakajo M, Kajiya Y, Tani A, Jinguji M, Nakajo M, Yoshiura T. FLT-PET/CT diagnosis of primary and metastatic nodal lesions of gastric cancer: comparison with FDG-PET/CT. Abdom Radiol (NY) 2016; 41:1891-8. [PMID: 27255652 DOI: 10.1007/s00261-016-0788-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To examine the diagnostic performance of (18)F-fluorothymidine (FLT)-PET/CT of primary and metastatic nodal lesions of gastric cancer by comparing with (18)F-fluorodeoxyglucose (FDG)-PET/CT. METHODS The enrolled study population comprised 17 patients with 17 newly diagnosed gastric cancers who underwent surgery of the primary lesion and regional nodes after both FDG- and FLT-PET/CT scans. Visual detectability of the primary gastric lesions was correlated with pathological factors using the Fisher exact or Mann-Whitney U test. The sensitivity, specificity, and accuracy in detecting nodal lesions were compared between both PET/CT scans using the McNemar exact or χ (2) test. RESULTS Fourteen of 17 (82.4%) primary cancers were visualized by both FDG- and FLT-PET/CT scans. Although FDG or FLT visibility was not significantly associated with tumor size (p = 0.16) or histological type (p = 1.00), the 3 nonvisible lesions were pathologically early (T1) cancers. The sensitivity, specificity, and accuracy for detecting nodal metastasis were 44.8% (13/29), 98.7% (164/166), and 90.8% (177/195) for FDG-PET/CT, and 31.0% (9/29), 100% (166/166), and 89.7% (175/195) for FLT-PET/CT, respectively. No significant difference was found between the two scans in sensitivity (p = 0.13), specificity (p = 0.48), or accuracy (p = 1.00). CONCLUSION FLT-PET/CT may have the same diagnostic value as FDG-PET/CT for detection of primary and nodal lesions of gastric cancer.
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Affiliation(s)
- Masatoyo Nakajo
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
- Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.
| | - Yoriko Kajiya
- Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan
| | - Atushi Tani
- Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan
| | - Megumi Jinguji
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Masayuki Nakajo
- Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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Mendler CT, Feuchtinger A, Heid I, Aichler M, D'Alessandria C, Pirsig S, Blechert B, Wester HJ, Braren R, Walch A, Skerra A, Schwaiger M. Tumor Uptake of Anti-CD20 Fabs Depends on Tumor Perfusion. J Nucl Med 2016; 57:1971-1977. [PMID: 27417649 DOI: 10.2967/jnumed.116.176784] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/21/2016] [Indexed: 12/22/2022] Open
Abstract
Antibodies have become an established treatment modality in cancer therapy during the last decade. However, these treatments often suffer from an insufficient and heterogeneous response despite validated antigen or target receptor expression in the tumor. In fact, therapeutic success depends on both the presence of the tumor antigen and its accessibility by the antibody. In search of a suitable preclinical animal model to evaluate the mechanisms of tumor heterogeneity and hemodynamics, we characterized two exemplary non-Hodgkin lymphoma subtypes with comparable CD20 expression and metabolism, SUDHL-4 and Granta-519, using multimodal imaging techniques. METHODS To investigate in vivo biodistribution, two differently modified αCD20 antigen-binding fragments (Fab), prepared by PASylation with a 200-residue polypeptide tag comprising Pro, Ala, and Ser (PAS200) and by fusion with an albumin-binding domain (ABD), were radiolabeled with 125I and intravenously injected into immunocompromised mice bearing corresponding xenografts. RESULTS Validation with 18F-FDG revealed a similar distribution in vital tumor tissue 1 h after injection. However, large differences in tumor uptake were observed when the CD20-specific radiotracers 125I-Fab-ABD and 125I-Fab-PAS200 were applied (respective percentages injected dose per gram at 24 h after injection: 12.3 and 2.4 for Granta-519 vs. 5.8 and 1.2 for SUDHL-4). Three-dimensional light-sheet fluorescence microscopy with Cy5-Fab-PAS200 confirmed better tracer extravasation in the Granta-519 tumors. Moreover, dynamic contrast-enhanced (DCE) MRI revealed significantly reduced perfusion in the SUDHL-4 tumors. CONCLUSION Tracer uptake was highly dependent on local tumor perfusion and Fab permeation in the SUDHL-4 and Granta-519 tumors. Thus, the SUDHL-4 xenograft offers an excellent model for investigating the influence of therapies affecting tumor angiogenesis.
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Affiliation(s)
- Claudia Theresa Mendler
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany .,Munich Center for Integrated Protein Science (CIPS-M) and Lehrstuhl für Biologische Chemie, Technische Universität München, Freising (Weihenstephan), Germany
| | - Annette Feuchtinger
- Research Unit Analytical Pathology, Institute of Pathology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Irina Heid
- Institute of Radiology, Klinikum rechts der Isar, Technische Universität München, München, Germany; and
| | - Michaela Aichler
- Research Unit Analytical Pathology, Institute of Pathology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Calogero D'Alessandria
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Sabine Pirsig
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Birgit Blechert
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Hans-Jürgen Wester
- Pharmaceutical Radiochemistry, Technische Universität München, Garching, Germany
| | - Rickmer Braren
- Institute of Radiology, Klinikum rechts der Isar, Technische Universität München, München, Germany; and
| | - Axel Walch
- Research Unit Analytical Pathology, Institute of Pathology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Arne Skerra
- Munich Center for Integrated Protein Science (CIPS-M) and Lehrstuhl für Biologische Chemie, Technische Universität München, Freising (Weihenstephan), Germany
| | - Markus Schwaiger
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Munthe E, Riss PJ, Saga TA, Haraldsen I, Grad I, Bogsrud TV, Bach-Gansmo T. FDG-based quantitative comparison of glucose metabolism in vitro, exemplified by a head-to-head comparison between a triple-negative breast cancer cell line and a non-malignant foetal cell line. Clin Physiol Funct Imaging 2016; 38:34-37. [PMID: 27297457 DOI: 10.1111/cpf.12378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Glucose metabolism can be studied in vitro by a variety of means, also by fluorodeoxyglucose (FDG). As an example of the potential use we have compared the high glucose consumption in cancer cells and in transformed non-malignant foetal cells. The high glucose metabolism in cancer cells is not primarily for the production of energy, a large proportion is transformed to lactate only, producing two instead of potentially 32 ATP equivalents. The secreted lactate reduces the pH in the local microenvironment and gives malignant cells, more apt to thrive in hypoxic and acid environments, a competitive advantage. PURPOSE To demonstrate the use of FDG in head-to-head comparison of glucose uptake and lactate production in a highly malignant and a highly proliferative non-malignant cell line. MATERIALS AND METHODS Cell cultures of a foetal kidney cell line and a triple negative breast cancer cell line were incubated with FDG for one hour, washed, harvested and the radioactivity content in the cells was measured in a well counter. The lactate concentration was measured in conditioned medium. RESULTS The FDG uptake was consistently higher in the non-malignant foetal cell line. The levels of lactate in the conditioned medium were similar. CONCLUSION Quantitative comparison of glucose metabolism by in vitro use of FDG is a practical, cheap and rapid method. Some foetal cells have higher glucose uptake and produce as much lactate as this highly malignant cell line. This is an argument against the high glucose consumption being related solely to malignancy.
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Affiliation(s)
- Else Munthe
- Department of Tumor biology, Oslo University Hospital, Radiumhospitalet, Oslo Cancer Cluster, Olso, Norway
| | | | - Thor A Saga
- Norwegian Medical Cyclotroncenter, Oslo, Norway
| | - Ira Haraldsen
- Department of psychiatry, Oslo University Hospital, Olso, Norway
| | - Iwona Grad
- Department of Tumor biology, Oslo University Hospital, Radiumhospitalet, Oslo Cancer Cluster, Olso, Norway
| | - Trond V Bogsrud
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.,Department of Nuclear Medicine and PET-Center, Aarhus University Hospital, Aarhus, Denmark
| | - Tore Bach-Gansmo
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
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Andersson M, Johansson L, Mattsson S, Minarik D, Leide-Svegborn S. ORGAN DOSES AND EFFECTIVE DOSE FOR FIVE PET RADIOPHARMACEUTICALS. RADIATION PROTECTION DOSIMETRY 2016; 169:253-258. [PMID: 26977075 DOI: 10.1093/rpd/ncw033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Diagnostic investigations with positron-emitting radiopharmaceuticals are dominated by (18)F-fluorodeoxyglucose ((18)F-FDG), but other radiopharmaceuticals are also commercially available or under development. Five of them, which are all clinically important, are (18)F-fluoride, (18)F-fluoroethyltyrosine ((18)F-FET), (18)F-deoxyfluorothymidine ((18)F-FLT), (18)F-fluorocholine ((18)F-choline) and (11)C-raclopride. To estimate the potential risk of stochastic effects (mainly lethal cancer) to a population, organ doses and effective dose values were updated for all five radiopharmaceuticals. Dose calculations were performed using the computer program IDAC2.0, which bases its calculations on the ICRP/ICRU adult reference voxel phantoms and the tissue weighting factors from ICRP publication 103. The biokinetic models were taken from ICRP publication 128. For organ doses, there are substantial changes. The only significant change in effective dose compared with previous estimations was a 46 % reduction for (18)F-fluoride. The estimated effective dose in mSv MBq(-1) was 1.5E-02 for (18)F-FET, 1.5E-02 for (18)F-FLT, 2.0E-02 for (18)F-choline, 9.0E-03 for (18)F-fluoride and 4.4E-03 for (11)C-raclopride.
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Affiliation(s)
- Martin Andersson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Lennart Johansson
- Radiation Physics, Department of Radiation Sciences, Umeå University, SE-901 87 Umeå, Sweden
| | - Sören Mattsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - David Minarik
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Sigrid Leide-Svegborn
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
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Hovhannisyan N, Dhilly M, Guillouet S, Leporrier M, Barré L. Comparative Analysis between [(18)F]Fludarabine-PET and [(18)F]FDG-PET in a Murine Model of Inflammation. Mol Pharm 2016; 13:2136-9. [PMID: 27080099 DOI: 10.1021/acs.molpharmaceut.6b00050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphoma research has advanced thanks to introduction of [(18)F]fludarabine, a positron-emitting tool. This novel radiotracer has been shown to display a great specificity for lymphoid tissues. However, in a benign process such as inflammation, the uptake of this tracer has not been questioned. Indeed, in inflammatory zones, elevated glucose metabolism rate may result in false-positives with [(18)F]FDG-PET Imaging. In the present investigation, it has been argued that cells, involved in inflammation, might be less avid of [(18)F]fludarabine. To generate inflammation, Swiss mice were intramuscularly injected with 0.1 mL of turpentine oil into the right front paw. Imaging sessions with (18)F-labeled tracers named above were conducted on days 5 and 25 after inoculation. For each animal, volumes of interest (VOI), delineating the muscle of the inflamed (IP) and normal paws (NP), were determined on PET scans. For characterization of inflammation, muscle samples from IP and NP were stained with hematoxylin and eosin (H&E). In early (day 5) inflammation, [(18)F]FDG accumulation was 4.00 ± 1.65 times greater in the IP than in the contralateral NP; for [(18)F]fludarabine, this IP/NP ratio was 1.31 ± 0.28, resulting in a significant difference between radiotracer groups (p < 0.01). In late (day 25) inflammation, the IP/NP ratios were 2.07 ± 0.49 and 1.03 ± 0.07, for [(18)F]FDG and [(18)F]fludarabine, respectively (p < 0.001). [(18)F]Fludarabine showed significantly weaker uptake in inflammation when compared with [(18)F]FDG. This encouraging finding suggests that [(18)F]fludarabine-PET might well be a robust approach for distinguishing tumor from inflammatory tissue, avoiding false-positive PET results and thus enabling an accurate imaging of lymphoma.
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Affiliation(s)
- Narinée Hovhannisyan
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France.,UNICAEN, UMR6301-ISTCT , F-14032 Caen, France.,UMR ISTCT 6301, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France
| | - Martine Dhilly
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France.,UNICAEN, UMR6301-ISTCT , F-14032 Caen, France.,UMR ISTCT 6301, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France
| | - Stéphane Guillouet
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France.,UNICAEN, UMR6301-ISTCT , F-14032 Caen, France.,UMR ISTCT 6301, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France
| | - Michel Leporrier
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France.,UNICAEN, UMR6301-ISTCT , F-14032 Caen, France.,UMR ISTCT 6301, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France
| | - Louisa Barré
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France.,UNICAEN, UMR6301-ISTCT , F-14032 Caen, France.,UMR ISTCT 6301, LDM-TEP group, GIP Cyceron , Boulevard Henri Becquerel, BP 5229, 14074 Caen Cedex, France
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Abstract
With the introduction of hybrid imaging technologies such as PET/CT and recently PET/MRI, staging and therapy-response monitoring have evolved. PET/CT has been shown to be of value for routine staging of FDG-avid lymphomas before as well as at the end of treatment. For interim staging, trials are ongoing to evaluate the use of PET/CT. In melanoma, PET/CT can be recommended for stages III and IV diseases for initial staging and before surgery. Studies investigating the use of PET/CT for early therapy response are promising. The role of PET/MR in lymphoma and melanoma imaging has to be defined because no larger studies exist so far. There may be an application of PET/MR in research especially for tumor characterization and therapy response. Furthermore, the potential role of non-FDG tracers is elucidated regarding the assessment of treatment response in targeted drug regimens.
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Affiliation(s)
- Nina F Schwenzer
- Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany.
| | - Anna Christina Pfannenberg
- Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany
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Minamimoto R, Fayad L, Advani R, Vose J, Macapinlac H, Meza J, Hankins J, Mottaghy F, Juweid M, Quon A. Diffuse Large B-Cell Lymphoma: Prospective Multicenter Comparison of Early Interim FLT PET/CT versus FDG PET/CT with IHP, EORTC, Deauville, and PERCIST Criteria for Early Therapeutic Monitoring. Radiology 2016; 280:220-9. [PMID: 26854705 DOI: 10.1148/radiol.2015150689] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To compare the performance characteristics of interim fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (after two cycles of chemotherapy) by using the most prominent standardized interpretive criteria (including International Harmonization Project [IHP] criteria, European Organization for Research and Treatment of Cancer [EORTC] criteria, and PET Response Criteria in Solid Tumors (PERCIST) versus those of interim (18)F fluorothymidine (FLT) PET/CT and simple visual interpretation. Materials and Methods This HIPAA-compliant prospective study was approved by the institutional review boards, and written informed consent was obtained. Patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) underwent both FLT and FDG PET/CT 18-24 days after two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. For FDG PET/CT interpretation, IHP criteria, EORTC criteria, PERCIST, Deauville criteria, standardized uptake value, total lesion glycolysis, and metabolic tumor volume were used. FLT PET/CT images were interpreted with visual assessment by two reviewers in consensus. The interim (after cycle 2) FDG and FLT PET/CT studies were then compared with the end-of-treatment FDG PET/CT studies to determine which interim examination and/or criteria best predicted the result after six cycles of chemotherapy. Results From November 2011 to May 2014, there were 60 potential patients for inclusion, of whom 46 patients (24 men [mean age, 60.9 years ± 13.7; range, 28-78 years] and 22 women [mean age, 57.2 years ± 13.4; range, 25-76 years]) fulfilled the criteria. Thirty-four patients had complete response, and 12 had residual disease at the end of treatment. FLT PET/CT had a significantly higher positive predictive value (PPV) (91%) in predicting residual disease than did any FDG PET/CT interpretation method (42%-46%). No difference in negative predictive value (NPV) was found between FLT PET/CT (94%) and FDG PET/CT (82%-95%), regardless of the interpretive criteria used. FLT PET/CT showed statistically higher (P < .001-.008) or similar NPVs than did FDG PET/CT. Conclusion Early interim FLT PET/CT had a significantly higher PPV than standardized FDG PET/CT-based interpretation for therapeutic response assessment in DLBCL. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Ryogo Minamimoto
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Luis Fayad
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Ranjana Advani
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Julie Vose
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Homer Macapinlac
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Jane Meza
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Jordan Hankins
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Felix Mottaghy
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Malik Juweid
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
| | - Andrew Quon
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, and Department of Medical Oncology (R.A.), Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5281 (R.M., A.Q.); Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, Calif (R.M.); Departments of Lymphoma/Myeloma (L.F.) and Nuclear Medicine (H.M.), the University of Texas, MD Anderson Cancer Center, Houston, Tex; Oncology/Hematology Section (J.V.) and Department of Radiology (J.H.), University of Nebraska Medical Center, Omaha, Neb; Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Neb (J.M.); Department of Nuclear Medicine, University Hospital of Aachen, Aachen, Germany (F.M.); and Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan (M.J.)
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11
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Cieslak JA, Sibenaller ZA, Walsh SA, Boles Ponto LL, Du J, Sunderland JJ, Cullen JJ. Fluorine-18-Labeled Thymidine Positron Emission Tomography (FLT-PET) as an Index of Cell Proliferation after Pharmacological Ascorbate-Based Therapy. Radiat Res 2016; 185:31-8. [PMID: 26720803 PMCID: PMC4720529 DOI: 10.1667/rr14203.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Pharmacological ascorbate (AscH(-)) induces cytotoxicity and oxidative stress selectively in pancreatic cancer cells compared with normal cells. Positron emission tomography (PET) with the thymidine analog 3'-deoxy-3'-((18)F) fluorothymidine (FLT) enables noninvasive imaging and quantification of the proliferation fraction of tumors. We hypothesized that the rate of tumor proliferation determined by FLT-PET imaging, would be inversely proportional to tumor susceptibility to pharmacological AscH(-)-based treatments. Indeed, there was decreased FLT uptake in human pancreatic cancer cells treated with AscH(-) in vitro, and this effect was abrogated by co-treatment with catalase. In separate experiments, cells were treated with AscH(-), ionizing radiation or a combination of both. These studies demonstrated that combined AscH(-) and radiation treatment resulted in a significant decrease in FLT uptake that directly correlated with decreased clonogenic survival. MicroPET (18)F-FLT scans of mice with pre-established tumors demonstrated that AscH(-) treatment induced radiosensitization compared to radiation treatment alone. These data support testing of pharmacological ascorbate as a radiosensitizer in pancreatic cancer as well as the use of FLT-PET to monitor response to therapy.
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Affiliation(s)
- John A. Cieslak
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Zita A. Sibenaller
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
| | - Susan A. Walsh
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Small Animal Imaging Core, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Laura L. Boles Ponto
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Department of Small Animal Imaging Core, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Juan Du
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
| | - John J. Sunderland
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Joseph J. Cullen
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Holden Comprehensive Cancer Center, Iowa City, Iowa
- Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
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12
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A pilot study of the value of 18F-fluoro-deoxy-thymidine PET/CT in predicting viable lymphoma in residual 18F-FDG avid masses after completion of therapy. Clin Nucl Med 2015; 39:874-81. [PMID: 25144214 DOI: 10.1097/rlu.0000000000000539] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite its success in diagnosing and staging lymphoma, F-FDG PET/CT can be falsely positive in areas of posttreatment inflammation. 3'-F-fluoro-3'-deoxy-l-thymidine (F-FLT) is a structural analog of the DNA constituent thymidine; its uptake correlates with cellular proliferation. This pilot study evaluates the ability of F-FLT PET/CT to distinguish viable lymphoma from posttreatment inflammatory changes in F-FDG avid residual masses. METHODS Twenty-one patients with lymphoma with at least 1 F-FDG avid residual mass after therapy underwent F-FLT PET/CT imaging. F-FDG and F-FLT uptake values were compared, including quantitative pharmacokinetic parameters extracted from the F-FLT time activity curves generated from dynamic data using graphical and nonlinear compartmental modeling. RESULTS The true nature of the residual mass was confirmed by biopsy in 12 patients (8 positive and 4 negative for viable lymphoma and by follow-up CT and/or repeat F-FDG PET/CT imaging over 1 year); among the remaining 9 patients, 7 lesions resolved or decreased and 2 showed growth indicative of lymphoma. F-FLT PET SUVest.max was significantly higher in tumors than in benign lesions (5.5 [2.2] vs 1.7 [0.6]; P < 0.0001), whereas the difference in F-FDG SUVs was not significant (malignant, 7.8 [3.8] vs benign, 5.4 [2.4]; P = 0.11). All of the benign lesions had an F-FLT SUVest.max of less than 3.0. CONCLUSIONS F-FLT shows improved specificity over F-FDG in distinguishing residual lymphoma from posttreatment inflammation and may be useful in the evaluation of patients with residual F-FDG-positive masses after completing therapy.
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13
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Herrmann K, Buck AK, Schuster T, Abbrederis K, Blümel C, Santi I, Rudelius M, Wester HJ, Peschel C, Schwaiger M, Dechow T, Keller U. Week one FLT-PET response predicts complete remission to R-CHOP and survival in DLBCL. Oncotarget 2015; 5:4050-9. [PMID: 24979177 PMCID: PMC4147305 DOI: 10.18632/oncotarget.1990] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Despite improved survival in the Rituximab (R) era, a considerable number of patients with diffuse large B-cell lymphoma (DLBCL) ultimately die from the disease. Functional imaging using [18F]fluorodeoxyglucose-PET is suggested for assessment of residual viable tumor very early during treatment but is compromised by non-specific tracer retention in inflammatory lesions. The PET tracer [18F]fluorodeoxythymidine (FLT) as surrogate marker of tumor proliferation may overcome this limitation. We present results of a prospective clinical study testing FLT-PET as superior and early predictor of response to chemotherapy and outcome in DLBCL. 54 patients underwent FLT-PET prior to and one week after the start of R-CHOP chemotherapy. Repetitive FLT-PET imaging was readily implemented into the diagnostic work-up. Our data demonstrate that the reduction of FLT standard uptake valuemean (SUVmean) and SUVmax one week after chemotherapy was significantly higher in patients achieving complete response (CR, n=48; non-CR, n=6; p<0.006). Martingale-residual and Cox proportional hazard analyses showed a significant monotonous decrease of mortality risk with increasing change in SUV. Consistent with these results, early FLT-PET response showed relevant discriminative ability in predicting CR. In conclusion, very early FLT-PET in the course of R-CHOP chemotherapy is feasible and enables identification of patients at risk for treatment failure.
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Affiliation(s)
- Ken Herrmann
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany. Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany. These Authors contributed equally to this work
| | - Andreas K Buck
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany. Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany. These Authors contributed equally to this work
| | - Tibor Schuster
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Kathrin Abbrederis
- III. Medical Department, Technische Universität München, Munich, Germany
| | - Christina Blümel
- Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Ivan Santi
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Martina Rudelius
- Institute of Pathology, Technische Universität München, Munich, Germany. Institute of Pathology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Hans-Jürgen Wester
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Christian Peschel
- III. Medical Department, Technische Universität München, Munich, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Tobias Dechow
- III. Medical Department, Technische Universität München, Munich, Germany. Oncology Ravensburg, Ravensburg, Germany
| | - Ulrich Keller
- III. Medical Department, Technische Universität München, Munich, Germany
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14
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Hovhannisyan N, Guillouet S, Fillesoye F, Dhilly M, Patin D, Galateau F, Leporrier M, Barré L. Evaluation of the specificity of [(18)F]fludarabine PET/CT in a xenograft model of follicular lymphoma: comparison with [(18)F]FDG and impact of rituximab therapy. EJNMMI Res 2015; 5:23. [PMID: 25977881 PMCID: PMC4414862 DOI: 10.1186/s13550-015-0101-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 03/25/2015] [Indexed: 12/22/2022] Open
Abstract
Background [18F]Fludarabine is a novel positron emission tomography (PET) radiotracer for imaging lymphoma. The purpose of this preclinical study was to evaluate the robustness of [18F]fludarabine during rituximab therapy. In addition, a comparison was made between [18F]fludarabine and [18F]fluorodeoxyglucose ([18F]FDG) with regard to their concordance with histologically derived data. Methods CB17-SCID mice bearing human follicular DOHH-2 lymphoma were treated once weekly with rituximab (10 mg/kg) or physiological saline over 3 weeks. To obtain the tracer uptake in the metabolically active volume of the tumour (MAVT), a background-level threshold was applied to the volume of interest (VOI) defined on computed tomography (CT) image. The tumour uptake analysis was performed with MAVT-based segmentation for data analysis of sequential [18F]fludarabine PET/CT studies and with total tumour-based segmentation for comparison with histologically derived data. Results The correlation between the MAVT and [18F]fludarabine accumulation (%ID) in those viable tissues was equally significant for both vehicle- or rituximab-treated mice; for these latter, the presence of lymphoid tissues at the end of imaging sessions was confirmed histologically. A stronger correlation was demonstrated between quantitative values extracted from [18F]fludarabine-PET and histology (r2 = 0.91, p < 0.001) when compared to [18F]FDG-PET (r2 = 0.55, p = 0.03). Conclusions [18F]Fludarabine uptake in the follicular lymphoma model compared favourably with [18F]FDG in terms of specificity for PET imaging and also remained robust for persistent viable tissues following rituximab therapy. [18F]Fludarabine PET/CT may be a promising approach to evaluate lymphoma, including their surveillance during therapy. Electronic supplementary material The online version of this article (doi:10.1186/s13550-015-0101-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Narinée Hovhannisyan
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Stéphane Guillouet
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Fabien Fillesoye
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Martine Dhilly
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Delphine Patin
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Françoise Galateau
- CHU de Caen, Service d'Anatomie Pathologique, Av. de la Côte de Nacre, BP 95182, 14033 Caen, Cedex France
| | - Michel Leporrier
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
| | - Louisa Barré
- CEA, DSV/I2BM, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France ; Université de Caen Basse-Normandie, Esplanade de la Paix, 14032 Caen, France ; CNRS, UMR ISTCT 6301, LDM-TEP group, GIP Cyceron, Bd Henri Becquerel, BP 5229, 14074 Caen, Cedex France
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15
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Wester HJ, Keller U, Schottelius M, Beer A, Philipp-Abbrederis K, Hoffmann F, Šimeček J, Gerngross C, Lassmann M, Herrmann K, Pellegata N, Rudelius M, Kessler H, Schwaiger M. Disclosing the CXCR4 expression in lymphoproliferative diseases by targeted molecular imaging. Theranostics 2015; 5:618-30. [PMID: 25825601 PMCID: PMC4377730 DOI: 10.7150/thno.11251] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 02/06/2015] [Indexed: 12/31/2022] Open
Abstract
Chemokine ligand-receptor interactions play a pivotal role in cell attraction and cellular trafficking, both in normal tissue homeostasis and in disease. In cancer, chemokine receptor-4 (CXCR4) expression is an adverse prognostic factor. Early clinical studies suggest that targeting CXCR4 with suitable high-affinity antagonists might be a novel means for therapy. In addition to the preclinical evaluation of [(68)Ga]Pentixafor in mice bearing human lymphoma xenografts as an exemplary CXCR4-expressing tumor entity, we report on the first clinical applications of [(68)Ga]Pentixafor-Positron Emission Tomography as a powerful method for CXCR4 imaging in cancer patients. [(68)Ga]Pentixafor binds with high affinity and selectivity to human CXCR4 and exhibits a favorable dosimetry. [(68)Ga]Pentixafor-PET provides images with excellent specificity and contrast. This non-invasive imaging technology for quantitative assessment of CXCR4 expression allows to further elucidate the role of CXCR4/CXCL12 ligand interaction in the pathogenesis and treatment of cancer, cardiovascular diseases and autoimmune and inflammatory disorders.
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16
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Fluorothymidine PET/CT in neurolymphomatosis. Clin Nucl Med 2014; 40:e290-2. [PMID: 25546221 DOI: 10.1097/rlu.0000000000000632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neurolymphomatosis, a rare extranodal lymphoma, may involve the cranial nerves, peripheral nerves, spinal nerve roots, or nerve plexus. F-FDG PET/CT however shows increased FDG uptake in the nerves but is not specific for malignancy. We report a patient with neurolymphomatosis who underwent F-FDG PET/CT and F-fluorothymidine PET/CT where both the scans showed increased tracer uptake in the right sciatic nerve, proven later as neurolymphomatosis on nerve biopsy. Furthermore, the F-FDG avid mediastinal lymph nodes did not show F-fluorothymidine avidity, suggesting an inflammatory etiology.
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17
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18FDG, [18F]FLT, [18F]FAZA, and 11C-methionine are suitable tracers for the diagnosis and in vivo follow-up of the efficacy of chemotherapy by miniPET in both multidrug resistant and sensitive human gynecologic tumor xenografts. BIOMED RESEARCH INTERNATIONAL 2014; 2014:787365. [PMID: 25309926 PMCID: PMC4182689 DOI: 10.1155/2014/787365] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 08/14/2014] [Accepted: 08/28/2014] [Indexed: 01/19/2023]
Abstract
Expression of multidrug pumps including P-glycoprotein (MDR1, ABCB1) in the plasma membrane of tumor cells often results in decreased intracellular accumulation of anticancer drugs causing serious impediment to successful chemotherapy. It has been shown earlier that combined treatment with UIC2 anti-Pgp monoclonal antibody (mAb) and cyclosporine A (CSA) is an effective way of blocking Pgp function. In the present work we investigated the suitability of four PET tumor diagnostic radiotracers including 2-[(18)F]fluoro-2-deoxy-D-glucose ((18)FDG), (11)C-methionine, 3'-deoxy-3'-[(18)F]fluorothymidine ((18)F-FLT), and [(18)F]fluoroazomycin-arabinofuranoside ((18)FAZA) for in vivo follow-up of the efficacy of chemotherapy in both Pgp positive (Pgp(+)) and negative (Pgp(-)) human tumor xenograft pairs raised in CB-17 SCID mice. Pgp(+) and Pgp(-) A2780AD/A2780 human ovarian carcinoma and KB-V1/KB-3-1 human epidermoid adenocarcinoma tumor xenografts were used to study the effect of the treatment with an anticancer drug doxorubicin combined with UIC2 and CSA. The combined treatment resulted in a significant decrease of both the tumor size and the accumulation of the tumor diagnostic tracers in the Pgp(+) tumors. Our results demonstrate that (18)FDG, (18)F-FLT, (18)FAZA, and (11)C-methionine are suitable PET tracers for the diagnosis and in vivo follow-up of the efficacy of tumor chemotherapy in both Pgp(+) and Pgp(-) human tumor xenografts by miniPET.
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18
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Yue JB, Yang J, Liu J, Lee J, Cabrera AR, Sun XD, Bai GH, Li YH, Yu JM. Histopathologic validation of 3′-deoxy-3′-18F-fluorothymidine PET for detecting tumor repopulation during fractionated radiotherapy of human FaDu squamous cell carcinoma in nude mice18F-FLT PET repopulation -->. Radiother Oncol 2014; 111:475-81. [DOI: 10.1016/j.radonc.2014.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 03/31/2014] [Accepted: 04/07/2014] [Indexed: 12/25/2022]
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Graf N, Li Z, Herrmann K, Weh D, Aichler M, Slawska J, Walch A, Peschel C, Schwaiger M, Buck AK, Dechow T, Keller U. Positron emission tomographic monitoring of dual phosphatidylinositol-3-kinase and mTOR inhibition in anaplastic large cell lymphoma. Onco Targets Ther 2014; 7:789-98. [PMID: 24920919 PMCID: PMC4043809 DOI: 10.2147/ott.s59314] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Dual phosphatidylinositol-3-kinase (PI3K)/mammalian target of rapamycin (mTOR) inhibition offers an attractive therapeutic strategy in anaplastic large cell lymphoma depending on oncogenic nucleophosmin-anaplastic lymphoma kinase (NPM-ALK) signaling. We tested the efficacy of a novel dual PI3K/mTOR inhibitor, NVP-BGT226 (BGT226), in two anaplastic large cell lymphoma cell lines in vitro and in vivo and performed an early response evaluation with positron emission tomography (PET) imaging using the standard tracer, 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and the thymidine analog, 3′-deoxy-3′-[18F] fluorothymidine (FLT). Methods The biological effects of BGT226 were determined in vitro in the NPM-ALK positive cell lines SU-DHL-1 and Karpas299 by 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, propidium iodide staining, and biochemical analysis of PI3K and mTOR downstream signaling. FDG-PET and FLT-PET were performed in immunodeficient mice bearing either SU-DHL-1 or Karpas299 xenografts at baseline and 7 days after initiation of treatment with BGT226. Lymphomas were removed for immunohistochemical analysis of proliferation and apoptosis to correlate PET findings with in vivo treatment effects. Results SU-DHL-1 cells showed sensitivity to BGT226 in vitro, with cell cycle arrest in G0/G1 phase and an IC50 in the low nanomolar range, in contrast with Karpas299 cells, which were mainly resistant to BGT226. In vivo, both FDG-PET and FLT-PET discriminated sensitive from resistant lymphoma, as indicated by a significant reduction of tumor-to-background ratios on day 7 in treated SU-DHL-1 lymphoma-bearing animals compared with the control group, but not in animals with Karpas299 xenografts. Imaging results correlated with a marked decrease in the proliferation marker Ki67, and a slight increase in the apoptotic marker, cleaved caspase 3, as revealed by immunostaining of explanted lymphoma tissue. Conclusion Dual PI3K/mTOR inhibition using BGT226 is effective in ALK-positive anaplastic large cell lymphoma and can be monitored with both FDG-PET and FLT-PET early on in the course of therapy.
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Affiliation(s)
- Nicolas Graf
- III Medical Department, Technische Universität München, Munich, Germany
| | - Zhoulei Li
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany ; Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Daniel Weh
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Michaela Aichler
- Research Unit Analytical Pathology, Helmholtz Zentrum München, Munich, Germany
| | - Jolanta Slawska
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Axel Walch
- Research Unit Analytical Pathology, Helmholtz Zentrum München, Munich, Germany
| | - Christian Peschel
- III Medical Department, Technische Universität München, Munich, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany ; Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Tobias Dechow
- III Medical Department, Technische Universität München, Munich, Germany
| | - Ulrich Keller
- III Medical Department, Technische Universität München, Munich, Germany
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Early monitoring antiangiogenesis treatment response of Sunitinib in U87MG Tumor Xenograft by (18)F-FLT MicroPET/CT imaging. BIOMED RESEARCH INTERNATIONAL 2014; 2014:218578. [PMID: 24860813 PMCID: PMC4000939 DOI: 10.1155/2014/218578] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 03/19/2014] [Indexed: 11/17/2022]
Abstract
AIM It was aimed to monitor early treatment response of Sunitinib in U87MG models mimicking glioblastoma multiforme by longitudinal (18)F-FLT microPET/CT imaging in this study. METHODS U87MG tumor mice were intragastrically injected with Sunitinib at a dose of 80 mg/kg for consecutive 7 days. (18)F-FLT microPET/CT scans were acquired on days 0, 1, 3, 7, and 13 after therapy. Tumor sizes and body weight were measured. Tumor samples were collected for immunohistochemical analysis of proliferation and microvessel density (MVD) with anti-Ki67 and anti-CD31, respectively. RESULTS The uptake ratios of tumor to the contralateral muscle (T/M) of (18)F-FLT in the Sunitinib group decreased from baseline to day 3 (T/M0 = 2.98 ± 0.33; T/M3 = 2.23 ± 0.36; P < 0.001), reached the bottom on day 7 (T/M7 = 1.96 ± 0.35; P < 0.001), and then recovered on day 13. The T/M of (18)F-FLT uptake in the control group remained around 3.0. There was no difference for the tumor size between both groups until day 11. (18)F-FLT uptakes of tumor were correlated with Ki67 staining index and MVD. CONCLUSION Early therapy response to Sunitinib could be predicted via (18)F-FLT PET, which will contribute to monitoring antiangiogenesis treatment.
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Meyer JP, Probst KC, Westwell AD. Radiochemical synthesis of 2'-[18F]-labelled and 3'-[18F]-labelled nucleosides for positron emission tomography imaging. J Labelled Comp Radiopharm 2014; 57:333-7. [PMID: 24692121 DOI: 10.1002/jlcr.3197] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/10/2014] [Accepted: 02/23/2014] [Indexed: 01/11/2023]
Abstract
This review article considers 2'-labelled and 3'-labelled nucleosides, which are of great importance as positron emission tomography (PET) probes in clinical diagnostics and PET research. Although the radiochemical preparation of several [(18)F]-labelled nucleosides such as [(18)F]fluorothymidine or [(18)F](fluoroarabinofuranosyl)cytosine has been accomplished within the last two decades, a number of potentially interesting nucleoside-based biomarkers are not yet available for automated good manufacturing practice production due to the lack of fast and efficient synthetic methods for late-stage [(18)F]-introduction. In order to meet recent demands for new PET-based biomarkers in various clinical applications, appropriate precursors that can easily be fluorinated and deprotected need to be developed.
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Affiliation(s)
- Jan-Philip Meyer
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff, CF10 3NB, Wales, UK; Wales Research & Diagnostic PET Imaging Centre (PETIC), Institute for Translation, Innovation, Methodology & Engagement (TIME), School of Medicine, Heath Park, Cardiff University, Cardiff, CF14 4XN, Wales, UK
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Abstract
PURPOSE OF REVIEW Cellular to animal to human studies are shedding light on metabolic pathways that contribute to sustaining lymphomagenesis. Old players with new metabolic tricks and new metabolic players come into the scene. The purpose of this review is to discuss the recent advances made in the field of lymphoma metabolism with special focus on the metabolic modulation of tumor promoting and suppressing pathways and, conversely, on the effect of these pathways on metabolite addiction. RECENT FINDINGS The basis for the high glucose uptake and glycolytic activity in lymphoma cells is now beginning to be understood. Recent findings suggest a greater role of nucleotide biosynthesis as a major driving force for glycolysis, especially during proliferation and cellular stress conditions. There is new evidence for an increasing contribution of glycine-folate metabolism deregulation in nucleotide biosynthesis, genome integrity and epigenetic maintenance. Expanding roles for MYC, PI3K and TP53 in regulating reactive oxygen production, glycolysis and glutaminolysis in lymphoma cells have been described. The identification of novel pathways has allowed the emergence of new 'antimetabolite' strategies to increase the therapeutic efficacy of current approaches. SUMMARY Metabolism in lymphomas must fulfill the general demands from cell proliferation and those specific to lymphomagenesis. Data emerging from preclinical studies are elucidating the metabolic pathways that contribute to maintaining the malignant phenotype in lymphomas. This has resulted in identification of novel pathways, some of which may have a clinical impact in the diagnosis, characterization and treatment of lymphoma subtypes.
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Usefulness of PET/CT for the Differentiation and Characterization of Periampullary Lesions. Clin Nucl Med 2013; 38:703-8. [DOI: 10.1097/rlu.0b013e31829b266a] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Gillebert Q, Gligorov J, Kerrou K. Modification du métabolisme tumoral au cours du traitement : suivi de la réponse thérapeutique par tomographie par émission de positons. ONCOLOGIE 2013. [DOI: 10.1007/s10269-013-2322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Diagnostic performance of 18F-fluorothymidine PET/CT for primary colorectal cancer and its lymph node metastasis: comparison with 18F-fluorodeoxyglucose PET/CT. Eur J Nucl Med Mol Imaging 2013; 40:1223-32. [DOI: 10.1007/s00259-013-2424-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 04/02/2013] [Indexed: 01/04/2023]
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