Article Figures & Data
Figures
- FIGURE 1.
Standards for Reporting of Diagnostic Accuracy Studies (STARD) flow diagram.
- FIGURE 2.
Kinetics of elimination of 99mTc-(HE)3-G3 from blood. Data were calculated on the basis of count rates in ROIs placed over hearts.
- FIGURE 3.
Anterior planar images at 2, 4, 6, and 24 h after injection of 3,000 μg of 99mTc-(HE)3-G3 (patient 24). Upper setting of scale window is 12% of maximum counts. Arrows point at lesions.
- FIGURE 4.
Representative anterior planar images of patients with HER2-positive and HER2-negative tumors 4 h after injections of 1,000, 2,000, or 3,000 μg of 99mTc-(HE)3-G3. Upper setting of scale window is same for all images, 12% of maximum count rate. Arrows point at lesions.
- FIGURE 5.
Primary tumor–to–contralateral site ratios after injections of 1,000, 2,000, and 3,000 μg of 99mTc-(HE)3-G3. *Marks significant (P < 0.05) difference. **Marks highly significant (P < 0.01) difference. ns = not significant.
- FIGURE 6.
Patient 26. (A) Immunohistochemistry analysis shows very low HER2 expression in biopsy material. (B) Anterior planar image at 4 h after injection; upper setting of scale window is 12% of maximum counts, showing tumor–to–contralateral site ratio typical for HER2-positive tumors. Immunohistochemistry analysis of surgery material shows areas with high (B) and low (C) HER2 expression. Magnification 400×. Black arrows show cells with low and red arrows show cells with high HER2 expression. Arrows point at tumor.
- FIGURE 7.
Patient 27. SPECT/CT (A) and CT (B) images of hepatic lesions. SPECT/CT (C) and CT (D) images of iliac bone lesions. Arrows point at lesions.
Tables
Patient Age (y) HER2 status in primary tumor before imaging (IHC/FISH) HER2 gene amplification (determined after imaging) Primary tumor status (ER/PgR) Clinical stage before imaging 1,000 μg; mean tumor size, 28 ± 11 mm 1 68 1+ (IHC) FISH- ER+/PgR- IIA (T2N0M0) 2 62 1+ (IHC) FISH- ER+/PgR+ I (T1N0M0) 3 66 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 4 48 0 (IHC) FISH- ER-/PgR- IIA (T2N0M0) 5 50 3+ (IHC) FISH+ ER+/PgR+ IIA (T2N0M0) 6 70 3+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 7 30 3+ (IHC) FISH+ ER+/PgR+ IIB (T2N1M0) 8 59 2+ (IHC)/FISH+ ER-/PgR- IIA (T2N0M0) 9 45 (IHC)3+ FISH- ER+/PgR- IIB (T2N1M0) 2,000 μg; mean tumor size, 25 ± 6 mm 10 50 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 11 57 1+ (IHC) FISH- ER+/PgR+ I (T1N0M0) 12 43 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 13 51 1+ (IHC) FISH- ER-/PgR- IIA (T2N0M0) 14 65 3+ (IHC) FISH+ ER+/PgR+ IIA (T2N0M0) 15 35 3+ (IHC) FISH+ ER+/PgR+ I (T1N0M0) 16 50 1+ (IHC)* FISH+ ER+/PgR+ IIA (T2N0M0) 17 68 2+ (IHC)/FISH+ ER+/PgR- IIA (T2N0M0) 18 68 3+ (IHC) FISH+ ER+/PgR+ IIA (T2N0M0) 3,000 μg; mean tumor size 22 ± 7 mm 19 37 1+ (IHC) FISH- ER-/PgR- IIA (T2N0M0) 20 45 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 21 56 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 22 45 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 23 36 1+ (IHC) FISH- ER+/PgR+ IIA (T2N0M0) 24 48 3+ (IHC) FISH+ ER+/PgR+ IIВ (T2N1M0) 25 58 3+ (IHC) FISH+ ER+/PgR+ IIA (T2N0M0) 26 47 1+ (IHC)* FISH+ ER+/PgR+ IIA (T2N0M0) 27 61 3+ (IHC) FISH+ ER+/PgR- IV (T4N3M1) 28 49 3+ (IHC) FISH+ ER+/PgR+ I (T1N0M0) * Postimaging FISH evaluation demonstrated HER2 gene amplification.
IHC = immunohistochemistry; ER = estrogen receptor; PgR = progesterone receptor;+ = positive; - = negative.
- TABLE 2.
Uptake of 99mTc in Tumor-Free Areas of Organs with Highest Uptake on SPECT Images After Injection of 99mTc-(HE)3-G3 (Decay Corrected)
2 h 4 h 6 h 24 h Organ 1,000 μg 2,000 μg 3,000 μg 1,000 μg 2,000 μg 3,000 μg 1,000 μg 2,000 μg 3,000 μg 1,000 μg 2,000 μg 3,000 μg Breast 2.1 ± 0.6 2.4 ± 0.6 2.4 ± 0.6 2.1 ± 0.4 2.0 ± 0.5 2.1 ± 0.5 2.3 ± 1.1 1.8 ± 0.5 1.9 ± 0.3 1.7 ± 0.2 1.7 ± 0.5 1.6 ± 0.4 Small intestines 2.5 ± 0.6 2.4 ± 0.5 2.9 ± 0.6 2.1 ± 0.4 2.2 ± 0.4 2.5 ± 0.6 2.1 ± 0.8 1.9 ± 0.5 2.0 ± 0.4 1.7 ± 0.4 1.7 ± 0.5 1.8 ± 0.6 Kidney 24 ± 5 28 ± 6 29 ± 11 22 ± 5 28 ± 6 29 ± 11 24 ± 5 28 ± 6 29 ± 11 21 ± 5 21 ± 5 26 ± 12 Liver 11 ± 2 6 ± 2* 5 ± 2* 12 ± 4 6 ± 2* 5 ± 2* 10 ± 3 6 ± 2* 4 ± 1* 9 ± 3 5 ± 2* 4 ± 2* Lungs 2.4 ± 0.6 2.4 ± 0.7 2.7 ± 0.9 2.2 ± 0.5 2.2 ± 0.7 2.2 ± 0.6 1.9 ± 0.6 2.0 ± 0.6 2.0 ± 0.4 1.9 ± 0.5 1.8 ± 0.6 1.6 ± 0.4 * Significant difference in uptake compared with injection of 1,000 μg 99mTc-(HE)3-G3.
Absorbed dose, mGy/MBq Site 1,000 μg 2,000 μg 3,000 μg Adrenals 0.031 ± 0.007 0.031 ± 0.007 0.032 ± 0.002 Brain 0.0010 ± 0.0004 0.0011 ± 0.0002 0.0012 ± 0.0001 Breasts 0.008 ± 0.002 0.007 ± 0.001 0.008 ± 0.001 Gallbladder wall 0.017 ± 0.003 0.015 ± 0.004 0.014 ± 0.002 LLI wall 0.005 ± 0.001 0.006 ± 0.003 0.006 ± 0.001 Small intestine 0.0076 ± 0.0010 0.009 ± 0.004 0.009 ± 0.002 Stomach wall 0.0060 ± 0.0008 0.006 ± 0.001 0.007 ± 0.002 ULI wall 0.007 ± 0.001 0.008 ± 0.003 0.009 ± 0.002 Heart wall 0.004 ± 0.001 0.004 ± 0.001 0.0042 ± 0.0007 Kidneys 0.10 ± 0.02 0.10 ± 0.03 0.13 ± 0.05 Liver 0.016 ± 0.003 0.011 ± 0.003* 0.0100 ± 0.0008* Lungs 0.005 ± 0.001 0.005 ± 0.001 0.006 ± 0.001 Muscle 0.0024 ± 0.0005 0.003 ± 0.001 0.0028 ± 0.0007 Ovaries 0.014 ± 0.005 0.014 ± 0.008 0.013 ± 0.003 Pancreas 0.012 ± 0.001 0.013 ± 0.003 0.016 ± 0.004 Red marrow 0.0033 ± 0.0007 0.004 ± 0.001 0.004 ± 0.001 Osteogenic cells 0.006 ± 0.002 0.006 ± 0.002 0.007 ± 0.001 Skin 0.0014 ± 0.0004 0.0015 ± 0.0003 0.0017 ± 0.0003 Spleen 0.010 ± 0.001 0.010 ± 0.003 0.012 ± 0.004 Thymus 0.006 ± 0.001 0.007 ± 0.003 0.0068 ± 0.0002 Thyroid 0.017 ± 0.003 0.018 ± 0.005 0.022 ± 0.003 Urinary bladder wall 0.013 ± 0.007 0.014 ± 0.009 0.019 ± 0.007 Uterus 0.008 ± 0.002 0.055 ± 0.01 0.009 ± 0.003 Total body 0.004 ± 0.001 0.004 ± 0.001 0.004 ± 0.001 Effective dose equivalent (mSv/MBq) 0.017 ± 0.002 0.020 ± 0.012 0.019 ± 0.005 Effective dose (mSv/MBq) 0.011 ± 0.001 0.012 ± 0.006 0.012 ± 0.003 * Significant (P < 0.05) difference with absorbed dose after the injection of 1,000 μg 99mTc-(HE)3-G3.
LLI = lower large intestine; ULI = upper large intestine.
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