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Biodistribution, Dosimetry and Metabolism of 11ß-Methoxy-(17, 20E/Z)-[¹²³I]Iodovinylestradiol in Healthy Women and Breast Cancer Patients

Department of Nuclear Medicine and Radiobiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada

Correspondence: For correspondence or reprints contact: Johan E. van Lier, PhD, Department of Nuclear Medicine and Radiobiology, Faculty of Medicine, Université de Sherbrooke, 3001, 12th Ave. N., Sherbrooke, Québec, Canada J1H 5N4.

ABSTRACT

The biodistribution and dosimetry of the 20E and 20Z stereoisomers of 11ß-methoxy-(17,20)-[¹²³I]iodovinylestradiol (MIVE) were evaluated in six healthy women. Tumor uptake and metabolism of the 20Z isomer were evaluated in 13 women referred after abnormal mammography or after discovery of a suspect mass at physical examination. Methods: The radiopharmaceuticals were prepared from their corresponding stannyl intermediates and administrated intravenously. Blood samples were drawn at different time intervals and urine was collected for up to 24 h. Metabolites were detected by radiochromatography. Tissue distribution was followed for up to 24 h by scintigraphic imaging. The dosimetry was computed according to the Medical Internal Radiation Dose scheme. Results: The 20E and 20Z isomers exhibit similar biodistribution and dosimetry patterns. Chromatographic analysis of plasma samples of healthy volunteers and cancer patients, as well as in vitro plasma incubations, confirmed the in vivo stability of (20Z)-[¹²³I]MIVE. Radioactivity was rapidly cleared from the blood by the liver and excreted through the gut, which received the highest radiation dose (0.211 mGy/MBq). The effective doses for the adult female and male phantom were 0.054 and 0.046 mSv/MBq, respectively. Among the 13 patients imaged with (20Z)-[¹²³I]MIVE, 3 had fibrocystic disease with no focal uptake, 8 had good agreement with in vitro estrogen receptor determination and 2 were false-positive. Conclusion: The radiation dose after intravenous administration of 20E- or (20Z)-[¹²³I]MIVE at imaging dose levels is within acceptable limits. There was a good correlation between uptake of (20Z)-[¹²³I]MIVE and the presence of estrogen receptors in breast cancer patients.

Key Words: estrogen receptors • iodovinylestradiol • 11ß-methoxy-(17,20E/Z)-[¹²³I]iodovinylestradiol • ¹²³I • breast cancer • SPECT

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