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Research ArticleOncology

11C-Sorafenib and 15O-H2O PET for Early Evaluation of Sorafenib Therapy

Lemonitsa H. Mammatas, Maqsood Yaqub, N. Harry Hendrikse, Otto S. Hoekstra, Richard J. Honeywell, Robert C. Schuit, Martijn Meijerink, Lothar A. Schwarte, Godefridus J. Peters, Henk M.W. Verheul, Adriaan A. Lammertsma and C. Willemien Menke-van der Houven van Oordt
Journal of Nuclear Medicine July 2021, 62 (7) 934-940; DOI: https://doi.org/10.2967/jnumed.120.251611
Lemonitsa H. Mammatas
1Department of Medical Oncology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
2Department of Medical Oncology, Reinier de Graaf Hospital, Delft, The Netherlands;
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Maqsood Yaqub
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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N. Harry Hendrikse
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Otto S. Hoekstra
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Richard J. Honeywell
1Department of Medical Oncology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Robert C. Schuit
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Martijn Meijerink
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Lothar A. Schwarte
4Department of Anesthesiology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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Godefridus J. Peters
1Department of Medical Oncology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
5Department of Biochemistry, University of Gdansk, Gdansk, Poland; and
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Henk M.W. Verheul
1Department of Medical Oncology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
6Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
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Adriaan A. Lammertsma
3Department of Radiology and Nuclear Medicine, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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C. Willemien Menke-van der Houven van Oordt
1Department of Medical Oncology, VUmc, Amsterdam UMC, Amsterdam, The Netherlands;
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  • FIGURE 1.
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    FIGURE 1.

    Study design.

  • FIGURE 2.
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    FIGURE 2.

    Biodistribution of 11C-sorafenib in different healthy tissues and tumor tissue. PRE = baseline; POST = after 14 d of sorafenib therapy.

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    FIGURE 3.

    Fusion 11C-sorafenib PET/CT (sum, 40–60 min), low-dose CT, and PET images from 3 patients showing 11C-sorafenib uptake in tumor lesions (arrows). Patient A, with hepatocellular carcinoma, has metastasis in left costa 4; patient B, with renal cell carcinoma, has metastasis in left adrenal gland; and patient C, with hepatocellular carcinoma, has large intraabdominal metastasis. Physiologic uptake can be seen in liver (*) and kidneys (Δ).

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    FIGURE 4.

    Tumor 11C-sorafenib VT on days 0 (A) and 14 (B) in lesions of patients with progressive disease (PD) and stable disease (SD).

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    FIGURE 5.

    Correlation between tumor 11C-sorafenib VT and tumor sorafenib concentration (A) or sorafenib tumor-to-plasma ratio (B) measured with LC-MS/MS.

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    FIGURE 6.

    (A) Correlation between tumor 11C-sorafenib VT and perfusion of tumor rim. (B) Tumor perfusion difference after 14 d of sorafenib treatment in patients with PD and SD.

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    TABLE 1

    Tumor and Plasma Sorafenib Concentrations Measured with LC-MS/MS and 11C-Sorafenib Tumor VT on Days 0 and 14

    VT
    PatientAge (y)SexTumorBiopsy siteTumor (μg/L)Plasma (μg/L)Tumor-to-plasma ratioDay 0Day 14Response
    152FDTCSkin3,3906,1000.560.720.27PD
    255MRCCSpleen3,4804,8600.720.400.23PD
    359MRCCAdrenal gland5,7006,8800.830.330.11SD
    469MHCC——6,180—1.52—PD
    566MRCCLung11,7509,6101.220.340.10SD
    660FRCCAdrenal gland3,0006,4900.462.110.71PD
    766MHCCLiver13,4006,8601.951.260.28PD
    859MRCCLung13,2007,5501.750.140.26PD
    • DTC = differentiated thyroid carcinoma; PD = progressive disease; RCC = renal cell carcinoma; SD = stable disease; HCC = hepatocellular carcinoma.

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Journal of Nuclear Medicine: 62 (7)
Journal of Nuclear Medicine
Vol. 62, Issue 7
July 1, 2021
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11C-Sorafenib and 15O-H2O PET for Early Evaluation of Sorafenib Therapy
Lemonitsa H. Mammatas, Maqsood Yaqub, N. Harry Hendrikse, Otto S. Hoekstra, Richard J. Honeywell, Robert C. Schuit, Martijn Meijerink, Lothar A. Schwarte, Godefridus J. Peters, Henk M.W. Verheul, Adriaan A. Lammertsma, C. Willemien Menke-van der Houven van Oordt
Journal of Nuclear Medicine Jul 2021, 62 (7) 934-940; DOI: 10.2967/jnumed.120.251611

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11C-Sorafenib and 15O-H2O PET for Early Evaluation of Sorafenib Therapy
Lemonitsa H. Mammatas, Maqsood Yaqub, N. Harry Hendrikse, Otto S. Hoekstra, Richard J. Honeywell, Robert C. Schuit, Martijn Meijerink, Lothar A. Schwarte, Godefridus J. Peters, Henk M.W. Verheul, Adriaan A. Lammertsma, C. Willemien Menke-van der Houven van Oordt
Journal of Nuclear Medicine Jul 2021, 62 (7) 934-940; DOI: 10.2967/jnumed.120.251611
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Keywords

  • imaging biomarker
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  • 11C-sorafenib
  • 15O-H2O
  • intratumor drug concentration
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