TY - JOUR T1 - <sup>99m</sup>Tc-Duramycin SPECT imaging of early tumor response to targeted therapy: a comparison with <sup>18</sup>F-FDG PET JF - Journal of Nuclear Medicine JO - J Nucl Med DO - 10.2967/jnumed.116.182014 SP - jnumed.116.182014 AU - Filipe Elvas AU - Jan Boddaert AU - Christel Vangestel AU - Koon Pak AU - Brian Gray AU - Samir Kumar-Singh AU - Steven Staelens AU - Sigrid Stroobants AU - Leonie wyffels Y1 - 2016/11/01 UR - http://jnm.snmjournals.org/content/early/2016/11/22/jnumed.116.182014.abstract N2 - Molecular imaging of cell death may provide a detailed readout of the cellular response to novel therapies and prognostic information on tumor treatment efficacy assisting in the design of individualized therapy. We compared the predictive power of cell death imaging using 99mTc-duramycin to current gold standard 18F-FDG for treatment response evaluation after targeted therapy. Methods: Early therapy response evaluation was assessed by 99mTc-duramycin SPECT and 18F-FDG PET imaging in treatment-sensitive COLO205 and treatment-resistant HT29 human colorectal cancer xenografts 24 hours after a single dose of conatumumab or IgG1 control. The specificity of 99mTc-duramycin for apoptosis was assessed using 99mTc-linear duramycin control radiotracer. Radiotracer uptake was validated ex vivo by gamma-counting and autoradiography, and compared with caspase-3 activation (CC3) and DNA fragmentation (TUNEL). Data were analyzed with the Student’s t test and Pearson correlation. All statistical tests were two-sided. Results: COLO205 tumor uptake of 99mTc-duramycin was increased 7-fold from baseline in conatumumab- versus IgG1-treated control mice (p&lt;0.001), in good correlation with histological analysis of apoptosis (CC3: r=0.842 and TUNEL: r=0.894, p&lt;0.001). No response was detected in HT29 tumors. No change in 99mTc-linear duramycin uptake could be detected in COLO205 tumors after treatment, indicating specificity of the 99mTc-duramycin tumor signal. 18F-FDG uptake was not significantly increased from baseline in conatumumab- versus IgG1-treated COLO205 and HT29 tumor bearing mice (P = 0.104 and P = 0.779, respectively), and did not correlate with immunohistochemical evidence of apoptosis. Conclusion: We have demonstrated that 99mTc-duramycin specifically accumulates in apoptotic tumors where 18F-FDG was not able to differentiate responding from non-responding tumors early after treatment. 99mTc-duramycin holds promise as a noninvasive imaging radiotracer for early treatment evaluation in the clinic. ER -