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Mortimer JE, Bading JR, Frankel PH, Carroll MI, Yuan Y, Park JM, Tumyan L, Gidwaney N, Poku EK, Shively JE, Colcher DM. Use of 64Cu-DOTA-Trastuzumab PET to Predict Response and Outcome of Patients Receiving Trastuzumab Emtansine for Metastatic Breast Cancer: A Pilot Study. J Nucl Med 2022; 63:1145-1148. [PMID: 34857660 PMCID: PMC9364339 DOI: 10.2967/jnumed.121.262940] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/08/2021] [Indexed: 02/03/2023] Open
Abstract
We hypothesized that functional imaging with 64Cu-DOTA-trastuzumab PET/CT would predict the response to the antibody-drug conjugate trastuzumab-emtansine (T-DM1). Methods: Ten women with metastatic human epidermal growth factor receptor 2-positive breast cancer underwent 18F-FDG PET/CT and 64Cu-DOTA-trastuzumab PET/CT on days 1 and 2 before treatment with T-DM1. Results: T-DM1-responsive patients had higher uptake than nonresponsive patients. Day 1 minimum SUVmax (5.6 vs. 2.8, P < 0.02), day 2 minimum SUVmax (8.1 vs. 3.2, P < 0.01), and day 2 average SUVmax (8.5 vs. 5.4, P < 0.05) for 64Cu-DOTA-trastuzumab all favored responding patients. Tumor-level response suggested threshold dependence on SUVmax Patients with a day 2 minimum SUVmax above versus below the threshold had a median time to treatment failure of 28 mo versus 2 mo (P < 0.02). Conclusion: Measurement of trastuzumab uptake in tumors via PET/CT is promising for identifying patients with metastatic breast cancer who will benefit from T-DM1.
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Affiliation(s)
- Joanne E. Mortimer
- Department of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, California
| | - James R. Bading
- Department of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, California
| | - Paul H. Frankel
- Department of Information Sciences, City of Hope, Duarte, California
| | - Mary I. Carroll
- Department of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, California
| | - Yuan Yuan
- Department of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, California
| | - Jinha M. Park
- Department of Radiology, City of Hope, Duarte, California; and
| | - Lusine Tumyan
- Department of Radiology, City of Hope, Duarte, California; and
| | - Nikita Gidwaney
- Department of Radiology, City of Hope, Duarte, California; and
| | - Erasmus K. Poku
- Department of Cancer Molecular Imaging and Therapy, Beckman Research Institute of the City of Hope, Duarte, California
| | - John E. Shively
- Department of Cancer Molecular Imaging and Therapy, Beckman Research Institute of the City of Hope, Duarte, California
| | - David M. Colcher
- Department of Cancer Molecular Imaging and Therapy, Beckman Research Institute of the City of Hope, Duarte, California
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Miyake KK, Kataoka M, Ishimori T, Matsumoto Y, Torii M, Takada M, Satoh Y, Kubota K, Satake H, Yakami M, Isoda H, Ikeda DM, Toi M, Nakamoto Y. A Proposed Dedicated Breast PET Lexicon: Standardization of Description and Reporting of Radiotracer Uptake in the Breast. Diagnostics (Basel) 2021; 11:diagnostics11071267. [PMID: 34359350 PMCID: PMC8306936 DOI: 10.3390/diagnostics11071267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Dedicated breast positron emission tomography (dbPET) is a new diagnostic imaging modality recently used in clinical practice for the detection of breast cancer and the assessment of tumor biology. dbPET has higher spatial resolution than that of conventional whole body PET systems, allowing recognition of detailed morphological attributes of radiotracer accumulation within the breast. 18F-fluorodeoxyglucose (18F-FDG) accumulation in the breast may be due to benign or malignant entities, and recent studies suggest that morphology characterization of 18F-FDG uptake could aid in estimating the probability of malignancy. However, across the world, there are many descriptors of breast 18F-FDG uptake, limiting comparisons between studies. In this article, we propose a lexicon for breast radiotracer uptake to standardize description and reporting of image findings on dbPET, consisting of terms for image quality, radiotracer fibroglandular uptake, breast lesion uptake.
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Affiliation(s)
- Kanae K. Miyake
- Department of Advanced Medical Imaging Research, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan
- Correspondence: ; Tel.: +81-75-751-3760; Fax: +81-75-771-9709
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.K.); (T.I.); (Y.N.)
| | - Takayoshi Ishimori
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.K.); (T.I.); (Y.N.)
| | - Yoshiaki Matsumoto
- Department of Breast Surgery, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (Y.M.); (M.T.); (M.T.)
- Preemptive Medicine and Lifestyle Related Disease Research Center, Kyoto University Hospital, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.Y.); (H.I.)
| | - Masae Torii
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama-City 640-8558, Wakayama, Japan;
| | - Masahiro Takada
- Department of Breast Surgery, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (Y.M.); (M.T.); (M.T.)
| | - Yoko Satoh
- Yamanashi PET Imaging Clinic, 3046-2 Shimokato, Chuo-City 409-3821, Yamanashi, Japan;
| | - Kazunori Kubota
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-City 343-8555, Saitama, Japan;
| | - Hiroko Satake
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya-City 466-8550, Aichi, Japan;
| | - Masahiro Yakami
- Preemptive Medicine and Lifestyle Related Disease Research Center, Kyoto University Hospital, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.Y.); (H.I.)
| | - Hiroyoshi Isoda
- Preemptive Medicine and Lifestyle Related Disease Research Center, Kyoto University Hospital, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.Y.); (H.I.)
| | - Debra M. Ikeda
- Department of Radiology, Stanford University School of Medicine, Breast Imaging, 875 Blake Wilbur Drive, Stanford, CA 94305-5826, USA;
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (Y.M.); (M.T.); (M.T.)
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-City 606-8507, Kyoto, Japan; (M.K.); (T.I.); (Y.N.)
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Samanta S, Jiang J, Hamdi M, Register AZ, Majewski S, Williams MB, Turkington TG, Tornai MP, Laforest R, O'Sullivan JA, Tai YC. Performance comparison of a dedicated total breast PET system with a clinical whole-body PET system: a simulation study. Phys Med Biol 2021; 66. [PMID: 33892480 DOI: 10.1088/1361-6560/abfb16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/23/2021] [Indexed: 11/12/2022]
Abstract
This paper presents a novel PET geometry for breast cancer imaging. The scanner consists of a 'stadium' (a rectangle with two semi-circles on opposite sides) shaped ring, along with anterior and posterior panels to provide high sensitivity and high spatial resolution for an imaging field-of-view (FOV) that include both breasts, mediastinum and axilla. We simulated this total-breast PET system using GATE and reconstructed the coincidence events using a GPU-based list-mode image reconstruction implementing maximum likelihood expectation-maximization (ML-EM) algorithm. The rear-panel is made up of a single layer of LSO crystals (3.2 × 3.2 × 20 mm3each), while the 'stadium'-shaped elongated ring and the anterior panel are made with dual-layered LSO crystals (1.6 × 1.6 × 6 mm3each). The energy resolution and coincidence resolving time of all detectors are assumed to be 12% and 250 ps full-width-at-half-maximum, respectively. Various sized simulated lesions (4, 5, 6 mm) having 4:1, 5:1, and 6:1 lesion-to-background radioactivity concentration ratios, mimicking different biological uptakes, were strategically located throughout a volumetric torso phantom. We compared system sensitivity and lesion detectability of the dedicated total-breast PET system to a state-of-the-art clinical whole-body PET scanner. The mean sensitivity of the total-breast PET system is 3.21 times greater than that of a whole-body PET scanner in the breast regions. The total-breast PET system also provides better contrast-recovery coefficients for lesions of all sizes and lesion-to-background ratios in the breast when compared to a reference clinical whole-body PET scanner. Receiver operating characteristics (ROC) study shows the area under the ROC curve is 0.948 and 0.924 for the total-breast system and the whole-body PET scanner, respectively, in the detection of 4 mm diameter lesions with 4:1 lesion-to-background ratio. This study demonstrates our novel geometry can provide an imaging FOV larger than conventional PEM systems to simultaneously image both breasts, chest wall and axillae with significantly improved lesion detectability in the breasts when compared to a whole-body PET scanner.
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Affiliation(s)
- Suranjana Samanta
- Department of Electrical Engineering, Washington University, St. Louis, MO, United States of America
| | - Jianyong Jiang
- Department of Radiology, Washington University, St. Louis, MO, United States of America
| | - Mahdjoub Hamdi
- Department of Radiology, Washington University, St. Louis, MO, United States of America
| | - Alan Z Register
- Departments of Radiology and Biomedical Engineering, Duke University, Durham, NC, United States of America
| | - Stanislaw Majewski
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
| | - Mark B Williams
- Department of Radiology, University of Virginia, Charlottesville, VA, United States of America
| | - Timothy G Turkington
- Departments of Radiology and Biomedical Engineering, Duke University, Durham, NC, United States of America
| | - Martin P Tornai
- Departments of Radiology and Biomedical Engineering, Duke University, Durham, NC, United States of America
| | - Richard Laforest
- Department of Radiology, Washington University, St. Louis, MO, United States of America
| | - Joseph A O'Sullivan
- Department of Electrical Engineering, Washington University, St. Louis, MO, United States of America
| | - Yuan-Chuan Tai
- Department of Electrical Engineering, Washington University, St. Louis, MO, United States of America.,Department of Radiology, Washington University, St. Louis, MO, United States of America
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