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In Vivo Prediction of Response to Antiestrogen Treatment in Estrogen Receptor-Positive Breast Cancer

Roelof J. Bennink, MD1, Geertjan van Tienhoven, MD, PhD2, Leonie J. Rijks, PhD1,3, Arnold L. Noorduyn, MD, PhD4, Anton G. Janssen, PhD3 and Gerrit W. Sloof, MD, PhD1

1 Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
2 Department of Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands
3 Amersham Health and Eindhoven University of Technology, Eindhoven, The Netherlands
4 Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands



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  		FIGURE 1. Anterior (left) and posterior (right) whole-body scintigraphy of patient 1. (A) Correlating bone scintigraphy shows multiple sites of pathologic uptake (arrow). (B) Baseline Z-123I-MIVE scintigraphy shows multiple sites of pathologic uptake (arrow) in axial skeleton, skull, and left pleura. (C) Z-123I-MIVE scintigraphy 4 wk after starting tamoxifen shows complete blocking of pathologic uptake in lesions visible on baseline scintigraphy. Thyroid uptake (C) is due to suboptimal blocking of free 123I uptake. Masking of intestinal and hepatic activity was done by computer processing after acquisition.

 


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  		FIGURE 2. Anterior (left) and posterior (right) planar Z-123I-MIVE scintigraphy of patient 8 before (A) and 3 wk after (B) starting tamoxifen. Baseline Z-123I-MIVE scintigraphy (A) shows diffuse increased uptake in right breast (T4 tumor) with persisting uptake after therapy (B). Masking of intestinal and hepatic activity was done by computer processing after acquisition.

 


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  		FIGURE 3. Progression-free survival in ER-positive breast carcinoma in responders and nonresponders after starting tamoxifen, with exclusion of patients with faint uptake on baseline scintigraphy. There is significant difference (P < 0.01) in progression-free survival between responders and nonresponders.

 




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