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^99mTc-MIBI Imaging as a Predictor of Therapy Response in Osteosarcoma Compared with Multidrug Resistance-Associated Protein and P-Glycoprotein Expression

Zeynep Burak, MD¹, Jean-Luc Moretti, MD, PhD², Özden Ersoy, MD³, Ulus Sanl, MD⁴, Mehmet Kantar, MD⁵, Feyzi Tamgac, MD² and Gülçin Basdemir, MD³

¹ Department of Nuclear Medicine, Ege University Medical Faculty, zmir, Turkey
² Research Unit of Tumoral Tracers, Avicenne University Hospital, Paris North University, Paris, France
³ Department of Pathology, Ege University Medical Faculty, zmir, Turkey
⁴ Department of Medical Oncology, Ege University Medical Faculty, zmir, Turkey
⁵ Department of Pediatric Oncology, Ege University Medical Faculty, zmir, Turkey

View larger version (19K): [in a new window]   FIGURE 1. WR% of 99mTc-MIBI with respect to level of MRP expression. Positive correlation is found between 99mTc-MIBI efflux and MRP score (P = 0.003).

View larger version (67K): [in a new window]   FIGURE 2. A 24-y-old woman with osteosarcoma in left humerus (patient 14). (A) Early 99mTc-MIBI image shows intense tracer accumulation in tumor. (B) Late 99mTc-MIBI study demonstrates significant clearance of 99mTc-MIBI (WR%, 40%). (C) Immunohistochemical analysis of biopsy specimen is consistent with strong and diffuse MRP expression.

View larger version (17K): [in a new window]   FIGURE 3. Significant difference is found between WR% of patients with high MRP expression (group B) and those with low MRP score (group A) (30.1% ± 8.6% vs. 20% ± 7.7%; P = 0.007).

View larger version (19K): [in a new window]   FIGURE 4. WR% of 99mTc-MIBI in group 1 (both Pgp and MRP negative) is significantly slower than that of group 2 (both Pgp and MRP positive), group 3 (Pgp positive and MRP negative), and group 4 (MRP positive and Pgp negative). Difference between groups 2, 3, and 4 is not significant (NS).