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Molecular Imaging and Biology
Published in: Molecular Imaging and Biology 6/2008

Open Access 01-11-2008 | Research Article

Blood Flow and Glucose Metabolism in Stage IV Breast Cancer: Heterogeneity of Response During Chemotherapy

Authors: Nanda Krak, Jacobus van der Hoeven, Otto Hoekstra, Jos Twisk, Elsken van der Wall, Adriaan Lammertsma

Published in: Molecular Imaging and Biology | Issue 6/2008

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Abstract

Objective

The purpose of the study was to compare early changes in blood flow (BF) and glucose metabolism (MRglu) in metastatic breast cancer lesions of patients treated with chemotherapy.

Methods

Eleven women with stage IV cancer and lesions in breast, lymph nodes, liver, and bone were scanned before treatment and after the first course of chemotherapy. BF, distribution volume of water (V d), MRglu/BF ratio, MRglu and its corresponding rate constants K 1 and k 3 were compared per tumor lesion before and during therapy.

Results

At baseline, mean BF and MRglu varied among different tumor lesions, but mean V d was comparable in all lesions. After one course of chemotherapy, mean MRglu decreased in all lesions. Mean BF decreased in breast and node lesions and increased in bone lesions. V d decreased in breast and nodes, but did not change in bone lesions. The MRglu/BF ratio decreased in breast and bone lesions and increased in node lesions. In patients with multiple tumor lesions BF and MRglu response could be very heterogeneous, even within similar types of metastases. BF and MRglu increased in lesions of patients who experienced early disease progression or showed no response during clinical follow-up.

Conclusion

BF and MRglu changes separately give unique information on different aspects of tumor response to chemotherapy. Changes in BF and MRglu parameters can be remarkably heterogeneous in patients with multiple lesions.
Literature
1.
Ghersi D, Wilcken N, Simes RJ (2005) A systematic review of taxane-containing regimens for metastatic breast cancer. Br J Cancer 93:293–301PubMedCrossRef
2.
Bergh J, Jönsson P-E, Glimelius B et al (2001) A systematic overview of chemotherapy effects in breast cancer. Acta Oncol 40:253–281PubMed
3.
Oshida M, Uno K, Suzuki M et al (1998) Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-d-glucose. Cancer 82:2227–2234PubMedCrossRef
4.
Uzzan B, Nicolas P, Cucherat M et al (2004) Microvessel density as a prognostic factor in women with breast cancer: a systematic review of the literature and meta-analysis. Cancer Res 64:2941–2955PubMedCrossRef
5.
Folkman J (2002) Role of angiogenesis in tumor growth and metastasis. Semin Oncol 29:15–18PubMed
6.
Dales JP, Garcia S, Meunier-Carpentier S et al (2005) Overexpression of hypoxia-inducible factor HIF-1alpha predicts early relapse in breast cancer: retrospective study in a series of 745 patients. Int J Cancer 116:734–739PubMedCrossRef
7.
Bos R, van der Groep P, Greijer AE et al (2003) Levels of hypoxia-inducible factor-1alpha independently predict prognosis in patients with lymph node negative breast carcinoma. Cancer 97:1573–1581PubMedCrossRef
8.
Esteva FJ, Valero V, Pusztai L et al (2001) Chemotherapy of metastatic breast cancer: what to expect in 2001 and beyond. Oncologist 6:133–146PubMedCrossRef
9.
Jansson T, Westlin JE, Ahlstrom et al (1995) Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation? J Clin Oncol 13:1470–1477PubMed
10.
Bassa P, Kim EE, Inoue T et al (1996) Evaluation of preoperative chemotherapy using PET with fluorine-18-fluorodeoxyglucose in breast cancer. J Nucl Med. 37:931–938PubMed
11.
Smith IC, Welch AE, Hutcheon AW et al (2000) Positron emission tomography using [(18)F]-fluorodeoxy-d-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol 18:1676–1688PubMed
12.
Schelling M, Avril N, Nahrig J et al (2000) Positron emission tomography using [(18)F]Fluorodeoxyglucose for monitoring primary chemotherapy in breast cancer. J Clin Oncol 18:1689–1695PubMed
13.
Mankoff DA, Dunnwald LK, Gralow JR et al (2002) Blood flow and metabolism in locally advanced breast cancer: relationship to response to therapy. J Nucl Med 43:500–509PubMed
14.
Mankoff DA, Dunnwald LK, Gralow JR et al (2003) Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med 44:1806–1814PubMed
15.
Wahl RL, Zasadny K, Helvie M et al (1993) Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol 11:2101–2111PubMed
16.
Gennari A, Donati S, Salvadori B et al (2000) Role of 2-[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the early assessment of response to chemotherapy in metastatic breast cancer patients. Clin Breast Cancer 1:156–163PubMedCrossRef
17.
Stafford SE, Gralow JR, Schubert EK et al (2002) Use of serial FDG PET to measure the response of bone-dominant breast cancer to therapy. Acad Radiol 9:913–921PubMedCrossRef
18.
Wilson CB, Lammertsma AA, McKenzie CG et al (1992) Measurements of blood flow and exchanging water space in breast tumors using positron emission tomography: a rapid and noninvasive dynamic method. Cancer Res 52:1592–1597PubMed
19.
Zasadny KR, Tatsumi M, Wahl RL (2003) FDG metabolism and uptake versus blood flow in women with untreated primary breast cancers. Eur J Nucl Med Mol Imaging 30:274–280PubMed
20.
Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216PubMedCrossRef
21.
Hoekstra C, Hoekstra O, Lammertsma AA (1999) On the use of image derived input functions in oncological FDG PET studies. Eur J Nucl Med 26:1489–1492PubMedCrossRef
22.
Boellaard R, van Lingen A, Lammertsma AA (2001) Experimental and clinical evaluation of iterative reconstruction (OSEM) in dynamic PET: quantitative characteristics and effects on kinetic modeling. J Nucl Med 42:808–817PubMed
23.
Van der Weerdt AP, Klein LJ, Boellaard R et al (2001) Image-derived input functions for determination of MRglu in cardiac 18F-FDG PET scans. J Nucl Med 42:1622–1629PubMed
24.
Krak NC, van der Hoeven JJ, Hoekstra O et al (2003) Measuring [(18)F]FDG uptake in breast cancer during chemotherapy: comparison of analytical methods. Eur J Nucl Med Mol Imaging 30:674–681PubMed
25.
Hoekstra CJ, Stroobants SG, Hoekstra OS et al (2002) Measurement of perfusion in stage IIIA-N2 non-small cell lung cancer using H(2)(15)O and positron emission tomography. Clin Cancer Res 8:2109–2115PubMed
26.
Krak NC, Boellaard R, Hoekstra OS et al (2005) Effects of ROI definition and reconstruction method on quantitative outcome and applicability in a response monitoring trial. Eur J Nucl Med Mol Imaging 32:294–301PubMedCrossRef
27.
Ziegler SI, Haberkorn U, Byrne H et al (1996) Measurement of liver blood flow using oxygen-15 labelled water and dynamic positron emission tomography: limitations of model description. Eur J Nucl Med 23:169–177PubMedCrossRef
28.
Patlak CS, Blasberg RG, Fenstermacher JD (1983) Graphical evaluation of blood-to-brain transfer constants from multiple- time uptake data. J Cereb Blood Flow Metab 3:1–7PubMed
29.
Phelps ME, Huang SC, Hoffman EJ (1979) Tomographic measurement of local cerebral glucose metabolic rate in humans with (F-18)2-fluoro-2-deoxy-d-glucose: validation of method. Ann Neurol 6:371–388PubMedCrossRef
30.
Brown NS, Bicknell R (2001) Hypoxia and oxidative stress in breast cancer. Oxidative stress: its effects on the growth, metastatic potential and response to therapy of breast cancer. Breast Cancer Res 3:323–327PubMedCrossRef
31.
Heimann R, Hellman S (2000) Individual characterisation of the metastatic capacity of human breast carcinoma. Eur J Cancer 36:1631–1639PubMedCrossRef
32.
Weidner N, Semple JP, Welch WR et al (1991) Tumor angiogenesis and metastasis—correlation in invasive breast carcinoma. N Engl J Med 324:1–8PubMed
33.
Kahn D, Weiner GJ, Ben-Haim S et al (1994) Positron emission tomographic measurement of bone marrow blood flow to the pelvis and lumbar vertebrae in young normal adults. Blood 83:958–963PubMed
34.
Tseng J, Dunnwald LK, Schubert EK et al (2004) 18F-FDG kinetics in locally advanced breast cancer: correlation with tumor blood flow and changes in response to neoadjuvant chemotherapy. J Nucl Med 45:1829–1837PubMed
35.
Anderson H, Price P (2002) Clinical measurement of blood flow in tumours using positron emission tomography: a review. Nucl Med Commun 23:131–138PubMedCrossRef
36.
Semenza GL, Roth PH, Fang HM et al (1994) Transcriptional regulation of genes encoding glycolytic enzymes by hypoxia inducible factor 1. J Biol Chem 269:23757–23763PubMed
37.
Hamaoka T, Madewell JE, Podoloff DA et al (2004) Bone imaging in metastatic breast cancer. J Clin Oncol 22:2942–2953PubMedCrossRef
38.
Morris MJ, Akhurst T, Osman I et al (2002) Fluorinated deoxyglucose positron emission tomography imaging in progressive metastatic prostate cancer. Urology. 59:913–918PubMedCrossRef
39.
Nakai T, Okuyama C, Kubota T et al (2005) Pitfalls of FDG-PET for the diagnosis of osteoblastic bone metastases in patients with breast cancer. Eur J Nucl Med Mol Imaging 32:1253–1258PubMedCrossRef
40.
Cook GJ, Houston S, Rubens R et al (1998) Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions. J Clin Oncol 16:3375–3379PubMed
Metadata
Title
Blood Flow and Glucose Metabolism in Stage IV Breast Cancer: Heterogeneity of Response During Chemotherapy
Authors
Nanda Krak
Jacobus van der Hoeven
Otto Hoekstra
Jos Twisk
Elsken van der Wall
Adriaan Lammertsma
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Molecular Imaging and Biology / Issue 6/2008
Print ISSN: 1536-1632
Electronic ISSN: 1860-2002
DOI
https://doi.org/10.1007/s11307-008-0163-2

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