Imaging early changes in proliferation at 1 week post chemotherapy: a pilot study in breast cancer patients with 3'-deoxy-3'-[18F]fluorothymidine positron emission tomography.

Abstract

PURPOSE:

3'-deoxy-3'-[18F]fluorothymidine positron emission tomography ([18F]FLT-PET) has been developed for imaging cell proliferation and findings correlate strongly with the Ki-67 labelling index in breast cancer. The aims of this pilot study were to define objective criteria for [18F]FLT response and to examine whether [18F]FLT-PET can be used to quantify early response of breast cancer to chemotherapy.

METHODS:

Seventeen discrete lesions in 13 patients with stage II-IV breast cancer were scanned prior to and at 1 week after treatment with combination 5-fluorouracil, epirubicin and cyclophosphamide (FEC) chemotherapy. The uptake at 90 min (SUV90) and irreversible trapping (Ki) of [18F]FLT were calculated for each tumour. The reproducibility of [18F]FLT-PET was determined in nine discrete lesions from eight patients who were scanned twice before chemotherapy. Clinical response was assessed at 60 days after commencing FEC.

RESULTS:

All tumours showed [18F]FLT uptake and this was reproducible in serial measurements (SD of mean % difference=10.5% and 15.1%, for SUV90 and Ki, respectively; test-retest correlation coefficient>or=0.97). Six patients had a significant clinical response (complete or partial) at day 60; these patients also had a significant reduction in [18F]FLT uptake at 1 week. Decreases in Ki and SUV90 at 1 week discriminated between clinical response and stable disease (p=0.022 for both parameters). In three patients with multiple lesions there was a mixed [18F]FLT response in primary tumours and metastases. [18F]FLT response generally preceded tumour size changes.

CONCLUSION:

[18F]FLT-PET can detect changes in breast cancer proliferation at 1 week after FEC chemotherapy.

• Authors: Laura Kenny, R Charles Coombes, David M Vigushin, Adil Al-Nahhas, Sami Shousha, Eric O Aboagye
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 34 Issue 9 Pg. 1339-47 (Sep 2007) ISSN: 1619-7070 [Print] Germany
• PMID: 17333178 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Dideoxynucleosides
• Ki-67 Antigen
• Epirubicin
• Cyclophosphamide
• alovudine
• Fluorouracil

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Breast Neoplasms (diagnosis, drug therapy, pathology)
• Cell Proliferation
• Cyclophosphamide (administration & dosage)
• Dideoxynucleosides (pharmacology)
• Epirubicin (administration & dosage)
• Female
• Fluorouracil (administration & dosage)
• Humans
• Ki-67 Antigen (biosynthesis)
• Kinetics
• Middle Aged
• Neoplasm Metastasis
• Positron-Emission Tomography (methods)
• Treatment Outcome