HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tseng, J. Articles by Mankoff, D. A. Search for Related Content PubMed PubMed Citation Articles by Tseng, J. Articles by Mankoff, D. A.

¹⁸F-FDG Kinetics in Locally Advanced Breast Cancer: Correlation with Tumor Blood Flow and Changes in Response to Neoadjuvant Chemotherapy

Division of Nuclear Medicine, Department of Radiology, University of Washington, Seattle, Washington

The aim of this study was to characterize the biologic response of locally advanced breast cancer (LABC) to chemotherapy using ¹⁵O-water–derived blood flow measurements and ¹⁸F-FDG–derived glucose metabolism rate parameters. Methods: Thirty-five LABC patients underwent PET with ¹⁵O-water and ¹⁸F-FDG before neoadjuvant chemotherapy and 2 mo after the initiation of treatment. Kinetic analysis for ¹⁵O-water was performed using a single tissue compartment model to calculate blood flow; a 2-tissue compartment model was used to estimate ¹⁸F-FDG rate parameters K₁, k₂, k₃, and the flux constant, K_i. Correlations and ratios between blood flow and ¹⁸F-FDG rate parameters were calculated and compared with pathologic tumor response. Results: Although blood flow and ¹⁸F-FDG transport (K₁) were correlated before chemotherapy, there was relatively poor correlation between blood flow and the phosphorylation constant (k₃) or the overall ¹⁸F-FDG flux (K_i). Blood flow and ¹⁸F-FDG flux were more closely matched after chemotherapy, with changes in k₃ accounting for the increased correlation. These findings were consistent with a decline in both the K_i/flow and k₃/flow ratios with therapy. The ratio of ¹⁸F-FDG flux to transport (K_i/K₁) after 2 mo of chemotherapy was predictive of ultimate response. Conclusion: The pattern of tumor glucose metabolism in LABC, as reflected by analysis of ¹⁸F-FDG rate parameters, changes after therapy, even in patients with modest clinical responses. This may indicate a change in tumor "metabolic phenotype" in response to treatment. A low ratio of glucose metabolism (reflected by K_i) to glucose delivery (reflected by K₁ and blood flow) after therapy is associated with a favorable response. Further work is needed to understand the tumor biology underlying these findings.

Key Words: ¹⁸F-FDG • ¹⁵O-water • blood flow • kinetic analysis • breast cancer • tumor biology • response to therapy • PET

Related articles in JNM:

THIS MONTH IN JNM

JNM 2004 45: 8A-9A. [Full Text]  

This article has been cited by other articles:

				D. A. Mankoff, L. K. Dunnwald, S. C. Partridge, and J. M. Specht Blood Flow-Metabolism Mismatch: Good for the Tumor, Bad for the Patient Clin. Cancer Res., September 1, 2009; 15(17): 5294 - 5296. [Abstract] [Full Text] [PDF]

				J. H. Lee, E. L. Rosen, and D. A. Mankoff The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 2--Response to Therapy, Other Indications, and Future Directions J. Nucl. Med., May 1, 2009; 50(5): 738 - 748. [Abstract] [Full Text] [PDF]

				N. Avril, S. Sassen, and R. Roylance Response to Therapy in Breast Cancer J. Nucl. Med., May 1, 2009; 50(Suppl_1): 55S - 63S. [Abstract] [Full Text] [PDF]

				J. Schwarz-Dose, M. Untch, R. Tiling, S. Sassen, S. Mahner, S. Kahlert, N. Harbeck, A. Lebeau, W. Brenner, M. Schwaiger, et al. Monitoring Primary Systemic Therapy of Large and Locally Advanced Breast Cancer by Using Sequential Positron Emission Tomography Imaging With [18F]Fluorodeoxyglucose J. Clin. Oncol., February 1, 2009; 27(4): 535 - 541. [Abstract] [Full Text] [PDF]

				M. A. Lodge, H. A. Jacene, R. Pili, and R. L. Wahl Reproducibility of Tumor Blood Flow Quantification with 15O-Water PET J. Nucl. Med., October 1, 2008; 49(10): 1620 - 1627. [Abstract] [Full Text] [PDF]

				L. K. Dunnwald, J. R. Gralow, G. K. Ellis, R. B. Livingston, H. M. Linden, J. M. Specht, R. K. Doot, T. J. Lawton, W. E. Barlow, B. F. Kurland, et al. Tumor Metabolism and Blood Flow Changes by Positron Emission Tomography: Relation to Survival in Patients Treated With Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer J. Clin. Oncol., September 20, 2008; 26(27): 4449 - 4457. [Abstract] [Full Text] [PDF]

				N. A. Mullani, R. S. Herbst, R. G. O'Neil, K. L. Gould, B. J. Barron, and J. L. Abbruzzese Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass 18F-FDG Uptake: A Comparison with 15O-Labeled Water-Measured Blood Flow J. Nucl. Med., April 1, 2008; 49(4): 517 - 523. [Abstract] [Full Text] [PDF]

				A. C. Wolff, D. Berry, L. A. Carey, M. Colleoni, M. Dowsett, M. Ellis, J. E. Garber, D. Mankoff, S. Paik, L. Pusztai, et al. Research Issues Affecting Preoperative Systemic Therapy for Operable Breast Cancer J. Clin. Oncol., February 10, 2008; 26(5): 806 - 813. [Abstract] [Full Text] [PDF]

				D. A. Mankoff, J. F. Eary, J. M. Link, M. Muzi, J. G. Rajendran, A. M. Spence, and K. A. Krohn Tumor-Specific Positron Emission Tomography Imaging in Patients: [18F] Fluorodeoxyglucose and Beyond Clin. Cancer Res., June 15, 2007; 13(12): 3460 - 3469. [Abstract] [Full Text] [PDF]

				M. Soret, S. L. Bacharach, and I. Buvat Partial-Volume Effect in PET Tumor Imaging J. Nucl. Med., June 1, 2007; 48(6): 932 - 945. [Abstract] [Full Text] [PDF]

				R. K. Doot, L. K. Dunnwald, E. K. Schubert, M. Muzi, L. M. Peterson, P. E. Kinahan, B. F. Kurland, and D. A. Mankoff Dynamic and Static Approaches to Quantifying 18F-FDG Uptake for Measuring Cancer Response to Therapy, Including the Effect of Granulocyte CSF J. Nucl. Med., June 1, 2007; 48(6): 920 - 925. [Abstract] [Full Text] [PDF]

				H. M. Linden, K. A. Krohn, R. B. Livingston, and D. A. Mankoff Monitoring targeted therapy: is fluorodeoxylucose uptake a marker of early response? Clin. Cancer Res., October 1, 2006; 12(19): 5608 - 5610. [Full Text] [PDF]

				C M L West and N Charnley The potential of PET to increase understanding of the biological basis of tumour and normal tissue response to radiotherapy Br. J. Radiol., November 1, 2005; Supplement_28(1): 50 - 54. [Abstract] [Full Text] [PDF]