RT Journal Article SR Electronic T1 Investigation of Factors Determining the Enhanced Permeability and Retention Effect in Subcutaneous Xenografts JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 601 OP 607 DO 10.2967/jnumed.115.166173 VO 57 IS 4 A1 Michiel Bolkestein A1 Erik de Blois A1 Stuart J. Koelewijn A1 Alexander M.M. Eggermont A1 Frank Grosveld A1 Marion de Jong A1 Gerben A. Koning YR 2016 UL http://jnm.snmjournals.org/content/57/4/601.abstract AB Liposomal chemotherapy offers several advantages over conventional therapies, including high intratumoral drug delivery, reduced side effects, prolonged circulation time, and the possibility to dose higher. The efficient delivery of liposomal chemotherapeutics relies, however, on the enhanced permeability and retention (EPR) effect, which refers to the ability of macromolecules to extravasate leaky tumor vessels and accumulate in the tumor tissue. Using a panel of human xenograft tumors, we evaluated the influence of the EPR effect on liposomal distribution in vivo by injection of pegylated liposomes radiolabeled with 111In. Liposomal accumulation in tumors and organs was followed over time by SPECT/CT imaging. We observed that fast-growing xenografts, which may be less representative of tumor development in patients, showed higher liposomal accumulation than slow-growing xenografts. Additionally, several other parameters known to influence the EPR effect were evaluated, such as blood and lymphatic vessel density, intratumoral hypoxia, and the presence of infiltrating macrophages. The investigation of various parameters showed a few correlations. Although hypoxia, proliferation, and macrophage presence were associated with tumor growth, no hard conclusions or predictions could be made regarding the EPR effect or liposomal uptake. However, liposomal uptake was significantly correlated with tumor growth, with fast-growing tumors showing a higher uptake, although no biological determinants could be elucidated to explain this correlation.