Lindholm Paula, Lapela Maria, Någren Kjell, Lehikoinen Pertti, Minn Heikki, Jyrkkiö Sirkku
Department of Oncology and Radiotherapy, University of Turku, P.O. Box 52, Fl-20521 Turku, Finland.
Nucl Med Commun. 2009 Jan;30(1):30-6. doi: 10.1097/mnm.0b013e328313b7bc.
Breast cancer is one of the principal oncological challenges in the Western world. Currently, there are only a few reliable predictive methods for monitoring treatment. We investigated the ability of carbon-11 methionine ("11C-MET) positron emission tomography (PET) to evaluate early response to therapy in advanced breast cancer.
Thirteen patients with metastases in the lungs/pleura, lymph nodes, soft tissue, or bones entered a MET PET study both before and after the first cycle of polychemotherapy (n=4), or after the first month of therapy with hormones (n=5), or low dose weekly cytostatics (n=3). One patient underwent three PET studies: before hormonal therapy, after 1 month of hormonal therapy, and after the first cycle of polychemotherapy (total, 27 studies). MET accumulation in the metastatic sites was measured as standardized uptake values (SUVs), and the pretreatment and post-treatment SUVs were compared with each other and the clinical follow-up data.
A total of 26 different metastatic sites were investigated in 13 patients. All metastases were visible by MET PET except one superficially spreading local skin recurrence, probably because of respiratory movements. Five new metastatic sites were detected. After therapy the SUVs decreased significantly (30-54%; P < 0.05) in all six responding metastatic sites, whereas the SUVs of nonresponding metastases decreased somewhat (11-130/%; n=4), remained stable (+/- 8%; n=10), or increased (13-23%; n=4) (P=NS). The SUVs of two nonresponding metastatic sites decreased clearly. Physiological MET uptake in the salivary glands, the myocardium, and the bone marrow did not disturb the image interpretation.
MET PET may be useful in assessing the early response to therapy in advanced breast cancer.
乳腺癌是西方世界主要的肿瘤学挑战之一。目前，用于监测治疗的可靠预测方法寥寥无几。我们研究了碳-11蛋氨酸（“11C-MET”）正电子发射断层扫描（PET）评估晚期乳腺癌治疗早期反应的能力。
13例肺/胸膜、淋巴结、软组织或骨转移患者在多药化疗的第一个周期之前和之后（n = 4），或在激素治疗的第一个月之后（n = 5），或低剂量每周细胞抑制剂治疗之后（n = 3）参加了一项MET PET研究。1例患者接受了3次PET研究：激素治疗前、激素治疗1个月后以及多药化疗的第一个周期后（共27项研究）。测量转移部位的MET积聚作为标准化摄取值（SUV），并将治疗前和治疗后的SUV相互比较以及与临床随访数据进行比较。
13例患者共研究了26个不同的转移部位。除一处浅表扩散的局部皮肤复发（可能由于呼吸运动）外，所有转移灶均能被MET PET检测到。检测到5个新的转移部位。治疗后，所有6个有反应的转移部位的SUV显著降低（30 - 54%；P < 0.05），而无反应转移灶的SUV有所降低（11 - 130%；n = 4）、保持稳定（±8%；n = 10）或升高（13 - 23%；n = 4）（P = 无显著性差异）。两个无反应转移部位的SUV明显降低。唾液腺、心肌和骨髓的生理性MET摄取不影响图像解读。
MET PET可能有助于评估晚期乳腺癌治疗的早期反应。
