Department of Cancer Medicine, Imperial College, London, UK.
Clin Cancer Res. 2010 Aug 15;16(16):4236-45. doi: 10.1158/1078-0432.CCR-10-0468. Epub 2010 Aug 3.
This study sought to evaluate the reproducibility of [(11)C]choline-positron emission tomography and the effect of trastuzumab in breast cancer.
Twenty-one patients with newly diagnosed and recurrent breast cancer stage II-IV had a baseline dynamic [(11)C]choline-PET scan, 10 patients had a second [(11)C]choline-PET scan to examine reproducibility, and 6 patients had a second scan within a month after trastuzumab. Analysis of [(11)C]choline uptake was measured as the semiquantitative standardized uptake value at 30 and 60 minutes (SUV(30) and SUV(60)), and quantitatively as the net irreversible retention of the radiotracer at steady-state (Ki) and plasma to tissue exchange at 60 minutes (IRF60min).
Breast tumor lesions in all patients were visualized by [(11)C]choline PET. The difference in tumor versus normal tissue uptake was significant for SUV(30), SUV(60), Ki, and IRF60 minutes (Wilcoxon P < 0.0001). At 60 minutes postinjection, 15.1 +/- 2.16% of plasma radioactivity was due to unmetabolized [(11)C]choline radioactivity. [(11)C]Choline uptake was reproducible in breast tumor lesions (r(2) = 0.9 for SUV, 0.9 for Ki, and 0.8 for IRF60). Early responses to trastuzumab measured by [(11)C]choline-PET were significant in three lesions occurring in two patients who responded clinically.
[(11)C]Choline-PET uptake variables can be reproducibly assessed. Initial studies show that trastuzumab decreases [(11)C]choline uptake.
本研究旨在评估 [(11)C]胆碱正电子发射断层扫描（PET）的可重复性及其在乳腺癌中的作用。
21 例新诊断和复发的乳腺癌 II-IV 期患者进行基线动态 [(11)C]胆碱-PET 扫描，10 例患者进行第二次 [(11)C]胆碱-PET 扫描以检查可重复性，6 例患者在曲妥珠单抗治疗后一个月内进行第二次扫描。[(11)C]胆碱摄取的分析以 30 分钟和 60 分钟的半定量标准化摄取值（SUV(30) 和 SUV(60)）进行测量，并以放射性示踪剂在稳态下的净不可逆保留（Ki）和 60 分钟时的血浆到组织交换（IRF60min）进行定量测量。
所有患者的乳腺癌病灶均通过 [(11)C]胆碱 PET 显影。SUV(30)、SUV(60)、Ki 和 IRF60min 的肿瘤与正常组织摄取差异具有统计学意义（Wilcoxon P < 0.0001）。注射后 60 分钟，15.1 +/- 2.16%的血浆放射性来自未代谢的 [(11)C]胆碱放射性。乳腺癌病灶中 [(11)C]胆碱摄取具有可重复性（SUV 的 r(2) = 0.9，Ki 的 r(2) = 0.9，IRF60 的 r(2) = 0.8）。在两名临床反应患者的三个病灶中，[(11)C]胆碱-PET 测量的早期对曲妥珠单抗的反应具有显著意义。
[(11)C]胆碱-PET 摄取变量可重复评估。初步研究表明，曲妥珠单抗降低 [(11)C]胆碱摄取。
