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Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?

Our purpose was to establish whether noninvasive measurement of changes in (18)F-fluoride metabolic flux to bone mineral (K(i)) by PET/CT can provide incremental value in response assessment of bone metastases in breast cancer compared with SUV(max) and SUV(mean). Methods: Twelve breast cancer patie...

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Autores principales: Azad, Gurdip K., Siddique, Musib, Taylor, Benjamin, Green, Adrian, O’Doherty, Jim, Gariani, Joanna, Blake, Glen M., Mansi, Janine, Goh, Vicky, Cook, Gary J.R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Nuclear Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424232/
https://www.ncbi.nlm.nih.gov/pubmed/30042160
http://dx.doi.org/10.2967/jnumed.118.208710
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author Azad, Gurdip K.
Siddique, Musib
Taylor, Benjamin
Green, Adrian
O’Doherty, Jim
Gariani, Joanna
Blake, Glen M.
Mansi, Janine
Goh, Vicky
Cook, Gary J.R.
author_facet Azad, Gurdip K.
Siddique, Musib
Taylor, Benjamin
Green, Adrian
O’Doherty, Jim
Gariani, Joanna
Blake, Glen M.
Mansi, Janine
Goh, Vicky
Cook, Gary J.R.
author_sort Azad, Gurdip K.
collection PubMed
description Our purpose was to establish whether noninvasive measurement of changes in (18)F-fluoride metabolic flux to bone mineral (K(i)) by PET/CT can provide incremental value in response assessment of bone metastases in breast cancer compared with SUV(max) and SUV(mean). Methods: Twelve breast cancer patients starting endocrine treatment for de novo or progressive bone metastases were included. Static (18)F-fluoride PET/CT scans were acquired 60 min after injection, before and 8 wk after commencing treatment. Venous blood samples were taken at 55 and 85 min after injection to measure plasma (18)F-fluoride activity concentrations, and K(i) in individual bone metastases was calculated using a previously validated method. Percentage changes in K(i), SUV(max), and SUV(mean) were calculated from the same index lesions (≤5 lesions) from each patient. Clinical response up to 24 wk, assessed in consensus by 2 experienced oncologists masked to PET imaging findings, was used as a reference standard. Results: Of the 4 patients with clinically progressive disease (PD), mean K(i) significantly increased (>25%) in all, SUV(max) in 3, and SUV(mean) in 2. Of the 8 non-PD patients, K(i) decreased or remained stable in 7, SUV(max) in 5, and SUV(mean) in 6. A significant mean percentage increase from baseline for K(i), compared with SUV(max) and SUV(mean), occurred in the 4 patients with PD (89.7% vs. 41.8% and 43.5%, respectively; P < 0.001). Conclusion: After 8 wk of endocrine treatment for bone-predominant metastatic breast cancer, K(i) more reliably differentiated PD from non-PD than did SUV(max) and SUV(mean), probably because measurement of SUV underestimates fluoride clearance by not considering changes in input function.
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spelling pubmed-64242322019-03-26 Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV? Azad, Gurdip K. Siddique, Musib Taylor, Benjamin Green, Adrian O’Doherty, Jim Gariani, Joanna Blake, Glen M. Mansi, Janine Goh, Vicky Cook, Gary J.R. J Nucl Med Clinical Our purpose was to establish whether noninvasive measurement of changes in (18)F-fluoride metabolic flux to bone mineral (K(i)) by PET/CT can provide incremental value in response assessment of bone metastases in breast cancer compared with SUV(max) and SUV(mean). Methods: Twelve breast cancer patients starting endocrine treatment for de novo or progressive bone metastases were included. Static (18)F-fluoride PET/CT scans were acquired 60 min after injection, before and 8 wk after commencing treatment. Venous blood samples were taken at 55 and 85 min after injection to measure plasma (18)F-fluoride activity concentrations, and K(i) in individual bone metastases was calculated using a previously validated method. Percentage changes in K(i), SUV(max), and SUV(mean) were calculated from the same index lesions (≤5 lesions) from each patient. Clinical response up to 24 wk, assessed in consensus by 2 experienced oncologists masked to PET imaging findings, was used as a reference standard. Results: Of the 4 patients with clinically progressive disease (PD), mean K(i) significantly increased (>25%) in all, SUV(max) in 3, and SUV(mean) in 2. Of the 8 non-PD patients, K(i) decreased or remained stable in 7, SUV(max) in 5, and SUV(mean) in 6. A significant mean percentage increase from baseline for K(i), compared with SUV(max) and SUV(mean), occurred in the 4 patients with PD (89.7% vs. 41.8% and 43.5%, respectively; P < 0.001). Conclusion: After 8 wk of endocrine treatment for bone-predominant metastatic breast cancer, K(i) more reliably differentiated PD from non-PD than did SUV(max) and SUV(mean), probably because measurement of SUV underestimates fluoride clearance by not considering changes in input function. Society of Nuclear Medicine 2019-03 /pmc/articles/PMC6424232/ /pubmed/30042160 http://dx.doi.org/10.2967/jnumed.118.208710 Text en © 2019 by the Society of Nuclear Medicine and Molecular Imaging. Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. License: https://creativecommons.org/licenses/by/4.0/. Details: http://jnm.snmjournals.org/site/misc/permission.xhtml.
spellingShingle Clinical
Azad, Gurdip K.
Siddique, Musib
Taylor, Benjamin
Green, Adrian
O’Doherty, Jim
Gariani, Joanna
Blake, Glen M.
Mansi, Janine
Goh, Vicky
Cook, Gary J.R.
Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title_full Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title_fullStr Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title_full_unstemmed Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title_short Is Response Assessment of Breast Cancer Bone Metastases Better with Measurement of (18)F-Fluoride Metabolic Flux Than with Measurement of (18)F-Fluoride PET/CT SUV?
title_sort is response assessment of breast cancer bone metastases better with measurement of (18)f-fluoride metabolic flux than with measurement of (18)f-fluoride pet/ct suv?
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424232/
https://www.ncbi.nlm.nih.gov/pubmed/30042160
http://dx.doi.org/10.2967/jnumed.118.208710
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