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Sietske B M Gaykema,
Adrienne H Brouwers,
Marjolijn N Lub-de Hooge,
Rick G Pleijhuis,
Hetty Timmer-Bosscha,
Linda Pot,
Gooitzen M van Dam,
Sibylle B van der Meulen, Johan R de Jong,
Joost Bart,
Jakob de Vries,
Liesbeth Jansen,
Elisabeth G E de Vries,
Carolien P Schröder
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ABSTRACT: Vascular endothelial growth factor (VEGF)-A is overexpressed in most malignant and premalignant breast lesions. VEGF-A can be visualized noninvasively with PET imaging and using the tracer (89)Zr-labeled bevacizumab. In this clinical feasibility study, we assessed whether VEGF-A in primary breast cancer can be visualized by (89)Zr-bevacizumab PET. METHODS: Before surgery, breast cancer patients underwent a PET/CT scan of the breasts and axillary regions 4 d after intravenous administration of 37 MBq of (89)Zr-bevacizumab per 5 mg. PET images were compared with standard imaging modalities. (89)Zr-bevacizumab uptake was quantified as the maximum standardized uptake value (SUVmax). VEGF-A levels in tumor and normal breast tissues were assessed with enzyme-linked immunosorbent assay. Data are presented as mean ± SD. RESULTS: Twenty-five of 26 breast tumors (mean size ± SD, 25.1 ± 19.8 mm; range, 4-80 mm) in 23 patients were visualized. SUVmax was higher in tumors (1.85 ± 1.22; range, 0.52-5.64) than in normal breasts (0.59 ± 0.37; range, 0.27-1.69; P < 0.001). The only tumor not detected on PET was 10 mm in diameter. Lymph node metastases were present in 10 axillary regions; 4 could be detected with PET (SUVmax, 2.66 ± 2.03; range, 1.32-5.68). VEGF-A levels in the 17 assessable tumors were higher than in normal breast tissue in all cases (VEGF-A/mg protein, 184 ± 169 pg vs. 10 ± 21 pg; P = 0.001), whereas (89)Zr-bevacizumab tumor uptake correlated with VEGF-A tumor levels (r = 0.49). CONCLUSION: VEGF-A in primary breast cancer can be visualized by means of (89)Zr-bevacizumab PET.
Journal of Nuclear Medicine 05/2013; · 6.38 Impact Factor
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Ghazaleh Ghobadi,
Sonja van der Veen,
Beatrijs Bartelds,
Rudolf A de Boer,
Michael G Dickinson, Johan R de Jong,
Hette Faber,
Maarten Niemantsverdriet,
Sytze Brandenburg,
Rolf M F Berger,
Johannes A Langendijk,
Robert P Coppes,
Peter van Luijk
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ABSTRACT: INTRODUCTION: The risk of early radiation-induced lung toxicity (RILT) limits the dose and efficacy of radiation therapy of thoracic tumors. In addition to lung dose, coirradiation of the heart is a known risk factor in the development RILT. The aim of this study was to identify the underlying physiology of the interaction between lung and heart in thoracic irradiation. METHODS AND MATERIALS: Rat hearts, lungs, or both were irradiated to 20 Gy using high-precision proton beams. Cardiopulmonary performance was assessed using breathing rate measurements and F(18)-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) scans biweekly and left- and right-sided cardiac hemodynamic measurements and histopathology analysis at 8 weeks postirradiation. RESULTS: Two to 12 weeks after heart irradiation, a pronounced defect in the uptake of (18)F-FDG in the left ventricle (LV) was observed. At 8 weeks postirradiation, this coincided with LV perivascular fibrosis, an increase in LV end-diastolic pressure, and pulmonary edema in the shielded lungs. Lung irradiation alone not only increased pulmonary artery pressure and perivascular edema but also induced an increased LV relaxation time. Combined irradiation of lung and heart induced pronounced increases in LV end-diastolic pressure and relaxation time, in addition to an increase in right ventricle end-diastolic pressure, indicative of biventricular diastolic dysfunction. Moreover, enhanced pulmonary edema, inflammation and fibrosis were also observed. CONCLUSIONS: Both lung and heart irradiation cause cardiac and pulmonary toxicity via different mechanisms. Thus, when combined, the loss of cardiopulmonary performance is intensified further, explaining the deleterious effects of heart and lung coirradiation. Our findings show for the first time the physiological mechanism underlying the development of a multiorgan complication, RILT. Reduction of dose to either of these organs offers new opportunities to improve radiation therapy treatment of thoracic tumors, potentially facilitating increased treatment doses and tumor control.
International journal of radiation oncology, biology, physics 09/2012; · 4.59 Impact Factor
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ABSTRACT: PurposePositron emission tomography (PET) using 6-[18F]fluoro-L-dihydroxyphenylalanine (18F-dopa) has an excellent sensitivity to detect carcinoid tumour lesions. 18F-dopa tumour uptake and the levels of biochemical tumour markers are mediated by tumour endocrine metabolic activity. We
evaluated whether total 18F-dopa tumour uptake on PET, defined as whole-body metabolic tumour burden (WBMTB), reflects tumour load per patient, as measured
with tumour markers.
MethodsSeventy-seven consecutive carcinoid patients who underwent an 18F-dopa PET scan in two previously published studies were analysed. For all tumour lesions mean standardised uptake values
(SUVs) at 40% of the maximal SUV and tumour volume on 18F-dopa PET were determined and multiplied to calculate a metabolic burden per lesion. WBMTB was the sum of the metabolic burden
of all individual lesions per patient. The 24-h urinary serotonin, urine and plasma 5-hydroxindoleacetic acid (5-HIAA), catecholamines
(nor)epinephrine, dopamine and their metabolites, measured in urine and plasma, and serum chromogranin A served as tumour
markers.
ResultsAll but 1 were evaluable for WBMTB; 74 patients had metastatic disease. 18F-dopa PET detected 979 lesions. SUVmax on 18F-dopa PET varied up to 29-fold between individual lesions within the same patients. WBMTB correlated with urinary serotonin
(r = 0.51) and urinary and plasma 5-HIAA (r = 0.78 and 0.66). WBMTB also correlated with urinary norepinephrine, epinephrine, dopamine and plasma dopamine, but not with
serum chromogranin A.
ConclusionTumour load per patient measured with 18F-dopa PET correlates with tumour markers of the serotonin and catecholamine pathway in urine and plasma in carcinoid patients,
reflecting metabolic tumour activity.
Keywords
18F-dopa PET–Carcinoid tumour–Whole-body metabolic tumour burden–5-HIAA
European journal of nuclear medicine and molecular imaging 04/2012; 38(10):1854-1861. · 4.99 Impact Factor
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ABSTRACT: Metallic prosthetic replacements, such as hip or knee implants, are known to cause strong streaking artefacts in CT images. These artefacts likely induce over- or underestimation of the activity concentration near the metallic implants when applying CT-based attenuation correction of positron emission tomography (PET) images. Since this degrades the diagnostic quality of the images, metal artefact reduction (MAR) prior to attenuation correction is required.
The proposed MAR method, referred to as virtual sinogram-based technique, replaces the projection bins of the sinogram that are influenced by metallic implants by a 2-D Clough-Tocher cubic interpolation scheme performed in an irregular grid, called Delaunay triangulated grid. To assess the performance of the proposed method, a physical phantom and 30 clinical PET/CT studies including hip prostheses were used. The results were compared to the method implemented on the Siemens Biograph mCT PET/CT scanner.
Both phantom and clinical studies revealed that the proposed method performs equally well as the Siemens MAR method in the regions corresponding to bright streaking artefacts and the artefact-free regions. However, in regions corresponding to dark streaking artefacts, the Siemens method does not seem to appropriately correct the tracer uptake while the proposed method consistently increased the uptake in the underestimated regions, thus bringing it to the expected level. This observation is corroborated by the experimental phantom study which demonstrates that the proposed method approaches the true activity concentration more closely.
The proposed MAR method allows more accurate CT-based attenuation correction of PET images and prevents misinterpretation of tracer uptake, which might be biased owing to the propagation of bright and dark streaking artefacts from CT images to the PET data following the attenuation correction procedure.
European Journal of Nuclear Medicine 08/2011; 38(12):2257-68. · 4.53 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: Positron emission tomography (PET) using 6-[18F]fluoro-L-dihydroxyphenylalanine (18F-dopa) has an excellent sensitivity to detect carcinoid tumour lesions. 18F-dopa tumour uptake and the levels of biochemical tumour markers are mediated by tumour endocrine metabolic activity. We evaluated whether total 18F-dopa tumour uptake on PET, defined as whole-body metabolic tumour burden (WBMTB), reflects tumour load per patient, as measured with tumour markers.
Seventy-seven consecutive carcinoid patients who underwent an 18F-dopa PET scan in two previously published studies were analysed. For all tumour lesions mean standardised uptake values (SUVs) at 40% of the maximal SUV and tumour volume on 18F-dopa PET were determined and multiplied to calculate a metabolic burden per lesion. WBMTB was the sum of the metabolic burden of all individual lesions per patient. The 24-h urinary serotonin, urine and plasma 5-hydroxindoleacetic acid (5-HIAA), catecholamines (nor)epinephrine, dopamine and their metabolites, measured in urine and plasma, and serum chromogranin A served as tumour markers.
All but 1 were evaluable for WBMTB; 74 patients had metastatic disease. 18F-dopa PET detected 979 lesions. SUVmax on 18F-dopa PET varied up to 29-fold between individual lesions within the same patients. WBMTB correlated with urinary serotonin (r=0.51) and urinary and plasma 5-HIAA (r=0.78 and 0.66). WBMTB also correlated with urinary norepinephrine, epinephrine, dopamine and plasma dopamine, but not with serum chromogranin A.
Tumour load per patient measured with 18F-dopa PET correlates with tumour markers of the serotonin and catecholamine pathway in urine and plasma in carcinoid patients, reflecting metabolic tumour activity.
European Journal of Nuclear Medicine 06/2011; 38(10):1854-61. · 4.53 Impact Factor
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Wouter B Nagengast,
Marjolijn N Lub-de Hooge,
Esther M E van Straten,
Schelto Kruijff,
Adrienne H Brouwers,
Wilfred F A den Dunnen, Johan R de Jong,
Harry Hollema,
Rudi A Dierckx,
Nanno H Mulder,
Elisabeth G E de Vries,
Harald J Hoekstra,
Geke A P Hospers
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ABSTRACT: A feasibility study was performed to investigate the presence of VEGF in melanoma lesions by VEGF-SPECT with (111)In-bevacizumab. In addition the effect of a single therapeutic bevacizumab dose on (111)In-bevacizumab uptake was compared with VEGF levels in resected melanoma lesions.
Eligible were patients with stage III/IV melanoma who presented with nodal recurrent disease. VEGF-SPECT was performed after administration of 100 Mbq (111)In-bevacizumab (8 mg) at days 0, 2, 4 and 7 post injection. Tumour visualisation and quantification were compared with CT and FDG-PET. On day 7 a single dose of 7.5mg/kg bevacizumab was administered intravenously. On day 21, a second tracer dose (111)In-bevacizumab was administered and scans were obtained on days 21, 25 and 28. Metastases were surgically resected within 2 weeks after the last VEGF-SPECT scan and immunohistological (IHC) VEGF tumour expression was compared with (111)In-bevacizumab tumour uptake.
Nine patients were included. FDG-PET and CT detected both in total 12 nodal lesions which were all visualised by VEGF-SPECT. At baseline, (111)In-bevacizumab tumour uptake varied 3-fold between and 1.6 ± 0.1-fold within patients. After a therapeutic dose of bevacizumab there was a 21 ± 4% reduction in (111)In-bevacizumab uptake. The (111)In-bevacizumab tumour uptake in the second series positively correlated with the VEGF-A expression in the resected tumour lesions.
VEGF-SPECT could visualise all known melanoma lesions. A single dose of bevacizumab slightly lowered (111)In-bevacizumab uptake. Future studies should elucidate the role of VEGF-SPECT in the selection of patients and the individual dosing of bevacizumab treatment.
European journal of cancer (Oxford, England: 1990) 03/2011; 47(10):1595-602. · 4.12 Impact Factor
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ABSTRACT: A new system is presented and evaluated for real-time monitoring of blood leakage during hyperthermic isolated limb perfusion (HILP) surgery, the Veenstra HILP system. This system incorporates two software models to determine blood leakage: a single-nuclide algorithm and a newly developed dual-nuclide algorithm. The latter algorithm has the advantage that, in principle, it is independent of system sensitivity and thus independent of changes in geometrical efficiency. A physical description of the system is given, together with the required hardware and software specifications.
In-vitro measurements, corresponding to the intended clinical use, are presented to investigate the relevant performance characteristics of the system: count rate linearity, measurement uncertainty, response time, and accuracy. As the Veenstra HILP system provides the opportunity to use different filter settings and averaging time, the influence of these settings on the time response and measurement uncertainty is described.
Count rate linearity was better than 1% for the count rate domain typically observed during HILP procedures. The response time of the system degrades with increasing total averaging time. In contrast, measurement uncertainty in the blood leakage factor improves with increasing radiotracer count rates and increasing total averaging time. For both blood leakage algorithms, measurement accuracy is better than 1.0 and 1.5%, respectively.
Measurements have shown that the system is well suited for the real-time monitoring of blood leakage during HILP surgery. Furthermore, a good agreement was observed between the theoretical and measured response time and measurement uncertainty.
Nuclear Medicine Communications 03/2011; 32(9):853-62. · 1.40 Impact Factor
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Wouter B Nagengast,
Marjolijn N Lub-de Hooge,
Sjoukje F Oosting,
Wilfred F A den Dunnen,
Frank-Jan Warnders,
Adrienne H Brouwers, Johan R de Jong,
Patricia M Price,
Harry Hollema,
Geke A P Hospers,
Philip H Elsinga,
Jan Willem Hesselink,
Jourik A Gietema,
Elisabeth G E de Vries
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ABSTRACT: Non-invasive imaging of angiogenesis could ease the optimization of antiangiogenesis treatments for cancer. In this study, we evaluated the role of VEGF-PET as a biomarker of dynamic angiogenic changes in tumors following treatment with the kinase inhibitor sunitinib. The effects of sunitinib treatment and withdrawal on the tumor was investigated using the new VEGF-PET tracer (89)Zr-ranibizumab as well as (18)F-FDG PET, and (15)O-water PET in mouse xenograft models of human cancer. The obtained imaging results were compared with tumor growth, VEGF plasma levels and immunohistologic analyzes. In contrast to (18)F-FDG and (15)O-water PET, VEGF-PET demonstrated dynamic changes during sunitinib treatment within the tumor with a strong decline in signal in the tumor center and only minimal reduction in tumor rim, with a pronounced rebound after sunitinib discontinuation. VEGF-PET results corresponded with tumor growth and immunohistochemical vascular- and tumor- markers. Our findings highlight the strengths of VEGF-PET imaging to allow serial analysis of angiogenic changes in different areas within a tumor.
Cancer Research 11/2010; 71(1):143-53. · 7.86 Impact Factor
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Wouter B Nagengast,
Maarten A de Korte,
Thijs H Oude Munnink,
Hetty Timmer-Bosscha,
Wifred F den Dunnen,
Harry Hollema, Johan R de Jong,
Michael R Jensen,
Cornelia Quadt,
Carlos Garcia-Echeverria,
Guus A M S van Dongen,
Marjolijn N Lub-de Hooge,
Carolien P Schröder,
Elisabeth G E de Vries
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ABSTRACT: Angiogenesis is a critical step in tumor development, in which vascular endothelial growth factor (VEGF) is a key growth aspect. Heat shock protein 90 (HSP90), a molecular chaperone, is essential for the activity of key proteins involved in VEGF transcription. Currently, no biomarkers to predict the effect of, or monitor, HSP90 inhibition therapy in individual patients exist. (89)Zr-bevacizumab PET provides a noninvasive tool to monitor tumor VEGF levels. The aim of this study was to investigate (89)Zr-bevacizumab PET for early antiangiogenic tumor response evaluation of treatment with the new HSP90 inhibitor NVP-AUY922. In xenografts of A2780 and its cisplatin-resistant CP70 human ovarian cancer subline, (89)Zr-bevacizumab small-animal PET was performed before and after NVP-AUY922 treatment and verified with histologic response and ex vivo tumor VEGF levels. Compared with pretreatment values, 2 wk of NVP-AUY922 treatment decreased (89)Zr-bevacizumab uptake by 44.4% (P = 0.0003) in A2780 xenografts, whereas tumor uptake was not affected in CP70 xenografts. The same pattern was observed in A2780 and CP70 tumor VEGF levels, measured with enzyme-linked immunosorbent assay, and mean vessel density after NVP-AUY922 treatment. These findings coincided with reduction in the proliferation rate, assessed by Ki67 staining, in A2780 tumor tissue only. CONCLUSION: (89)Zr-bevacizumab PET was in line with the antiangiogenic response and direct antitumor effects after NVP-AUY922 treatment, supporting the specificity of (89)Zr-bevacizumab PET as a sensitive technique to monitor the antiangiogenic response of HSP90 inhibition in vivo.
Journal of Nuclear Medicine 05/2010; 51(5):761-7. · 6.38 Impact Factor
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Thijs H Oude Munnink,
Maarten A de Korte,
Wouter B Nagengast,
Hetty Timmer-Bosscha,
Carolina P Schröder, Johan R de Jong,
Guus A M S van Dongen,
Michael Rugaard Jensen,
Cornelia Quadt,
Marjolijn N Lub-de Hooge,
Elisabeth G E de Vries
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ABSTRACT: NVP-AUY922, a potent heat shock protein (HSP) 90 inhibitor, downregulates the expression of many oncogenic proteins, including the human epidermal growth factor receptor-2 (HER2). Because HER2 downregulation is a potential biomarker for early response to HSP90-targeted therapies, we used the (89)Zr-labelled HER2 antibody trastuzumab to quantify the alterations in HER2 expression after NVP-AUY922 treatment with HER2 positron emission tomography (PET) imaging. The HER2 overexpressing human SKOV-3 ovarian tumour cell line was used for in vitro experiments and as xenograft model in nude athymic mice. In vitro HER2 membrane expression was assessed by flow cytometry and a radio-immuno assay with (89)Zr-trastuzumab. For in vivo evaluation, mice received 50mg/kg NVP-AUY922 intraperitoneally every other day. (89)Zr-trastuzumab was injected intravenously 6d before NVP-AUY922 treatment and after 3 NVP-AUY922 doses. MicroPET imaging was performed at 24, 72 and 144h post tracer injection followed by ex-vivo biodistribution and immunohistochemical staining. After 24h NVP-AUY922 treatment HER2 membrane expression showed profound reduction with flow cytometry (80%) and radio-immuno assay (75%). PET tumour quantification, showed a mean reduction of 41% (p=0.0001) in (89)Zr-trastuzumab uptake at 144h post tracer injection after NVP-AUY922 treatment. PET results were confirmed by ex-vivo (89)Zr-trastuzumab biodistribution and HER2 immunohistochemical staining. NVP-AUY922 effectively downregulates HER2, which can be monitored and quantified in vivo non-invasively with (89)Zr-trastuzumab PET. This technique is currently under clinical evaluation and might serve as an early biomarker for HSP90 inhibition in HER2 positive metastatic breast cancer patients.
European journal of cancer (Oxford, England: 1990) 02/2010; 46(3):678-84. · 4.12 Impact Factor
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ABSTRACT: Many neurological and psychiatric disorders are associated with neuroinflammation. Positron emission tomography (PET) with [(11)C]-PK11195 can be used to study neuroinflammation in these disorders. However, [(11)C]-PK11195 may not be sensitive enough to visualize mild neuroinflammation. As a potentially more sensitive PET tracer for neuroinflammation, [(11)C]-N-(2,5-dimethoxybenzyl)-N-(4-fluoro-2-phenoxyphenyl)-acetamide (DAA1106) was evaluated in a rat model of herpes encephalitis.
Male Wistar rats were intranasally inoculated with HSV-1 (HSE) or phosphate-buffered saline (control). At Day 6 or Day 7 after inoculation, small-animal [(11)C]-DAA1106 PET scans were acquired, followed by ex vivo biodistribution. Arterial blood sampling was performed for quantification of uptake.
In HSE rats, a significantly higher ex vivo, but not in vivo, uptake of [(11)C]-DAA1106 was found in almost all examined brain areas (24-71%, P<.05), when compared to control rats. Pretreatment with unlabeled PK11195 effectively reduced [(11)C]-DAA1106 uptake in HSE rats (54-84%; P<.001). The plasma and brain time-activity curves showed rapid uptake of [(11)C]-DAA1106 into tissue. The data showed a good fit to the Logan analysis but could not be fitted to a two-tissue compartment model.
[(11)C]-DAA1106 showed a high and specific ex vivo uptake in the encephalitic rat brain. However, neuroinflammation could not be demonstrated in vivo by [(11)C]-DAA1106 PET. Quantification of the uptake of [(11)C]-DAA1106 using plasma sampling is not optimal, due to rapid tissue uptake, slow tissue clearance and low plasma activity.
Nuclear Medicine and Biology 01/2010; 37(1):9-15. · 3.02 Impact Factor
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Helle-Brit Fiebrich,
Adrienne H Brouwers,
Michiel N Kerstens,
Milan E J Pijl,
Ido P Kema, Johan R de Jong,
Pieter L Jager,
Philip H Elsinga,
Rudi A J O Dierckx,
Jacqueline E van der Wal,
Wim J Sluiter,
Elisabeth G E de Vries,
Thera P Links
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ABSTRACT: Catecholamine excess is rare, but symptoms may be life threatening.
The objective of the study was to investigate the sensitivity of 6-[F-18]fluoro-l-dihydroxyphenylalanine positron emission tomography ((18)F-DOPA PET), compared with (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy and computer tomography (CT)/magnetic resonance imaging (MRI) for tumor localization in patients with catecholamine excess.
All consecutive patients with catecholamine excess visiting the University Medical Center Groningen, Groningen, The Netherlands, between March 2003 and January 2008 were eligible.
Forty-eight patients were included. The final diagnosis was pheochromocytoma in 40, adrenal hyperplasia in two, paraganglioma in two, ganglioneuroma in one, and unknown in three.
Sensitivities and discordancy between (18)F-DOPA PET, (123)I-MIBG, and CT or MRI were analyzed for individual patients and lesions. Metanephrines and 3-methoxytyramine in plasma and urine and uptake of (18)F-DOPA with PET were measured to determine the whole-body metabolic burden and correlated with biochemical tumor activity. The gold standard was a composite reference standard.
(18)F-DOPA PET showed lesions in 43 patients, (123)I-MIBG in 31, and CT/MRI in 32. Patient-based sensitivity for (18)F-DOPA PET, (123)I-MIBG, and CT/MRI was 90, 65, and 67% (P < 0.01 for (18)F-DOPA PET vs. both (123)I-MIBG and CT/MRI, P = 1.0 (123)I-MIBG vs. CT/MRI). Lesion-based sensitivities were 73, 48, and 44% (P < 0.001 for (18)F-DOPA PET vs. both (123)I-MIBG and CT/MRI, P = 0.51 (123)I-MIBG vs. CT/MRI). The combination of (18)F-DOPA PET with CT/MRI was superior to (123)I-MIBG with CT/MRI (93 vs. 76%, P < 0.001). Whole-body metabolic burden measured with (18)F-DOPA PET correlated with plasma normetanephrine (r = 0.82), urinary normetanephrine (r = 0.84), and metanephrine (r = 0.57).
To localize tumors causing catecholamine excess, (18)F-DOPA PET is superior to (123)I-MIBG scintigraphy and CT/MRI.
The Journal of clinical endocrinology and metabolism 08/2009; 94(10):3922-30. · 6.50 Impact Factor
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Aren van Waarde,
Nisha K Ramakrishnan,
Anna A Rybczynska,
Philip H Elsinga,
Francesco Berardi, Johan R de Jong,
Chantal Kwizera,
Roberto Perrone,
Mariangela Cantore,
Jurgen W A Sijbesma,
Rudi A Dierckx,
Nicola A Colabufo
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ABSTRACT: P-glycoprotein (P-gp) is an ATP-dependent efflux pump protecting the body against xenobiotics. A P-gp substrate (7) and an inhibitor (6) were labeled with (11)C, resulting in potential tracers of P-gp function and expression.
6 and 7 were labeled using (11)CH(3)I. (11)C-verapamil was prepared as published previously, using (11)C-methyl triflate. MicroPET scans (with arterial sampling) and biodistribution studies were performed in rats pretreated with saline, cyclosporin A (CsA, 50 mg/kg), or cold 6 (15 mg/kg).
The radiochemical yields of (11)C-6 and (11)C-7 were approximately 30% with a total synthesis time of 45 min. Cerebral distribution volumes (DV) of (11)C-6 (2.35 +/- 0.11) and (11)C-7 (1.86 +/- 0.15) in saline-treated rats were higher than of (11)C-verapamil (0.64 +/- 0.12). DVs of (11)C-7 and (11)C-verapamil were significantly increased by CsA (to 5.26 +/- 0.14 and 5.85 +/- 0.32, respectively). The DV of (11)C-6 was reduced by cold 6 (to 1.65 +/- 0.03). Its uptake was also reduced (up to 67%) in several peripheral organs that express P-gp.
(11)C-7 is a novel tracer of P-gp function with higher baseline uptake than (11)C-verapamil. Upregulation of P-gp function in response to treatment (which is hard to detect with (11)C-verapamil) may be detectable using (11)C-7 and PET. Because (11)C-6 shows specific binding in target organs, this compound is the first PET tracer allowing measurement of P-gp expression.
Journal of Medicinal Chemistry 07/2009; 52(14):4524-32. · 4.80 Impact Factor
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ABSTRACT: The anti-human epidermal growth factor receptor 2 (HER2/neu) antibody trastuzumab is administered to patients with HER2/neu-overexpressing breast cancer. Whole-body noninvasive HER2/neu scintigraphy could help to assess and quantify the HER2/neu expression of all lesions, including nonaccessible metastases. The aims of this study were to develop clinical-grade radiolabeled trastuzumab for clinical HER2/neu immunoPET scintigraphy, to improve diagnostic imaging, to guide antibody-based therapy, and to support early antibody development. The PET radiopharmaceutical (89)Zr-trastuzumab was compared with the SPECT tracer (111)In-trastuzumab, which we have tested in the clinic already.
Trastuzumab was labeled with (89)Zr and (for comparison) with (111)In. The minimal dose of trastuzumab required for optimal small-animal PET imaging and biodistribution was determined with human HER2/neu-positive or -negative tumor xenograft-bearing mice.
Trastuzumab was efficiently radiolabeled with (89)Zr at a high radiochemical purity and specific activity. The antigen-binding capacity was preserved, and the radiopharmaceutical proved to be stable for up to 7 d in solvent and human serum. Of the tested protein doses, the minimal dose of trastuzumab (100 microg) proved to be optimal for imaging. The comparative biodistribution study showed a higher level of (89)Zr-trastuzumab in HER2/neu-positive tumors than in HER2/neu-negative tumors, especially at day 6 (33.4 +/- 7.6 [mean +/- SEM] vs. 7.1 +/- 0.7 percentage injected dose per gram of tissue). There were good correlations between the small-animal PET images and the biodistribution data and between (89)Zr-trastuzumab and (111)In-trastuzumab uptake in tumors (R(2) = 0.972).
Clinical-grade (89)Zr-trastuzumab showed high and HER2/neu-specific tumor uptake at a good resolution.
Journal of Nuclear Medicine 06/2009; 50(6):974-81. · 6.38 Impact Factor
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ABSTRACT: Intraobserver reliability and agreement were determined for microradiography (MR), micro-computed tomography (microCT) and histomorphometry (HM). These three modalities were compared for quantitative measurements of bone formation and graft modelling in rat mandibular defects and grafts.
Twelve rats were randomly selected from a larger experiment, evaluating bone formation in rat mandibular defects and bone modelling in grafts. Twelve lateral microradiographs were taken of the grafts. microCT images were obtained from all defects and grafts (24 specimens). Defects and grafts were cut perpendicularly through their centre. Microradiographs, microCT images and histological sections were obtained from the resulting 48 specimens. New bone volume and graft volume were measured using image analysis software on MR and microCT images. Defect width and graft width were measured using images from HM, MR and microCT. The results were compared to each other.
The intraobserver reliabilities for the measurements of new bone volume by microCT, and the measurement of graft modelling by MR and graft volume by microCT were high. The differences between MR, HM and microCT were larger in defect width measurements than in graft width measurement. MR measured smaller defects than HM and microCT. The 95% confidence interval was larger in defect width measurements compared to graft width measurements.
The methods of MR and microCT image analysis are reliable but preferably should be used in combination as to obtain valid conclusions. HM, MR and microCT for graft widths measurements showed more agreement than for defect width measurements. MR appears to overestimate bone formation.
Archives of Oral Biology 07/2008; 53(6):558-66. · 1.60 Impact Factor
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ABSTRACT: The objectives of this study were to determine whether a new degradable synthetic barrier membrane (Vivosorb) composed of poly(dl-lactide-epsilon-caprolactone) (PDLLCL) can be useful in implant dentistry and to compare it with collagen and expanded polytetrafluoroethylene (ePTFE) membranes.
In 192 male Sprague-Dawley rats, a standardized 5 mm circular defect was created through the right angle of the mandible. New bone formation was evaluated by post-mortem microradiography and micro-CT (muCT) imaging. Four groups (control, PDLLCL, collagen, ePTFE) were evaluated at three time intervals (2, 4, and 12 weeks). In the membrane groups the defects were covered; in the control group the defects were left uncovered. Data were analysed using a multiple regression model.
New bone formation could be detected by post-mortem microradiography in 130 samples and by muCT imaging in 112 samples. Bone formation was progressive in 12 weeks, when the mandibular defect was covered with a membrane. Overall, more bone formation was observed underneath the collagen and ePTFE membranes than the PDLLCL membranes.
In contrast to uncovered mandibular defects, substantial bone healing was observed in defects covered with a PDLLCL membrane. However, bone formation in PDLLCL-covered defects tended to be less than in the defects covered with collagen or ePTFE. The high variation in the PDLLCL samples at 12 weeks may be caused by the moderate adherence of this membrane to bone compared with collagen. These results indicate that further study is needed to optimize the properties of PDLLCL membranes.
Clinical Oral Implants Research 06/2008; 19(5):516-21. · 2.51 Impact Factor
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ABSTRACT: Sigma-receptors are strongly overexpressed in most rodent and human tumors and are proliferation markers. To evaluate the potential of a radiolabeled sigma1-ligand for therapy monitoring, we compared early changes of 11C-1-(3,4-dimethoxyphenethyl)-4-(3-phenylpropyl)piperazine (11C-SA4503) binding and 18F-FDG uptake in gliomas after in vivo chemotherapy.
C6 cells (2.5 x 10(6)) were subcutaneously injected into the right shoulder of male Wistar rats. After 7 d, the tumor volume was 0.60 +/- 0.08 cm3. Animals then received either saline or doxorubicin (8 mg/kg, intraperitoneally). One control and 1 treated rat were imaged simultaneously, 24 or 48 h after treatment, under pentobarbital anesthesia. Rodents (n = 20) were scanned first with 11C-SA4503 (25 MBq, intravenously) followed more than 100 min afterward by 18F-FDG (20 MBq, intravenously), using a dedicated small-animal PET camera (60-min protocol, tumors in the field of view). Tumor homogenates were prepared and subjected to sigma-receptor assays. The biodistribution of 18F-FDG was assessed.
Tumors appeared 4-5 d after inoculation and grew exponentially. No significant reduction of tumor growth was visible within 48 h after doxorubicin treatment. Both PET tracers visualized the tumors and showed reduced uptake after chemotherapy (11C-SA4503: 26.5% +/- 6.5% at 24 h, 26.5% +/- 7.5% at 48 h; 18F-FDG: 22.6% +/- 3.2% at 24 h, 27.4% +/- 3.2% at 48 h; ex vivo 18F-FDG: 22.4% +/- 5.4% at 24 h, 31.7% +/- 12.7% at 48 h). Sigma1-receptor density in treated tumors was also reduced (from 172 +/- 35 to 125 +/- 28 fmol/mg of protein).
Both 11C-SA4503 binding and 18F-FDG uptake declined in gliomas after chemotherapy. Decreased binding of 11C-SA4503 corresponded to a loss of sigma1-receptors from the tumors. Changes in tracer uptake preceded the morphologic changes by at least 48 h.
Journal of Nuclear Medicine 09/2007; 48(8):1320-6. · 6.38 Impact Factor
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ABSTRACT: Vascular endothelial growth factor (VEGF), released by tumor cells, is an important growth factor in tumor angiogenesis. The humanized monoclonal antibody bevacizumab blocks VEGF-induced tumor angiogenesis by binding, thereby neutralizing VEGF. Our aim was to develop radiolabeled bevacizumab for noninvasive in vivo VEGF visualization and quantification with the single gamma-emitting isotope 111In and the PET isotope 89Zr.
Labeling, stability, and binding studies were performed. Nude mice with a human SKOV-3 ovarian tumor xenograft were injected with 89Zr-bevacizumab, 111In-bevacizumab, or human 89Zr-IgG. Human 89Zr-IgG served as an aspecific control antibody. Small-animal PET and microCT studies were obtained at 24, 72, and 168 h after injection of 89Zr-bevacizumab and 89Zr-IgG (3.5 +/- 0.5 MBq, 100 +/- 6 microg, 0.2 mL [mean +/- SD]). Small-animal PET and microCT images were fused to calculate tumor uptake and compared with ex vivo biodistribution at 168 h after injection. 89Zr- and 111In-bevacizumab ex vivo biodistribution was compared at 24, 72, and 168 h after injection (2.0 +/- 0.5 MBq each, 100 +/- 4 microg in total, 0.2 mL).
Labeling efficiencies, radiochemical purity, stability, and binding properties were optimal for the radioimmunoconjugates. Small-animal PET showed uptake in well-perfused organs at 24 h and clear tumor localization from 72 h onward. Tumor uptake determined by quantification of small-animal PET images was higher for 89Zr-bevacizumab-namely, 7.38 +/- 2.06 %ID/g compared with 3.39 +/- 1.16 %ID/g (percentage injected dose per gram) for human 89Zr-IgG (P = 0.011) at 168 h and equivalent to ex vivo biodistribution studies. Tracer uptake in other organs was seen primarily in liver and spleen. 89Zr- and 111In-bevacizumab biodistribution was comparable.
Radiolabeled bevacizumab showed higher uptake compared with radiolabeled human IgG in a human SKOV-3 ovarian tumor xenograft. Noninvasive quantitative small-animal PET was similar to invasive ex vivo biodistribution. Radiolabeled bevacizumab is a new tracer for noninvasive in vivo imaging of VEGF in the tumor microenvironment.
Journal of Nuclear Medicine 09/2007; 48(8):1313-9. · 6.38 Impact Factor
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ABSTRACT: Positron-emitting beta-adrenoceptor ligands for the CNS could allow determination of changes in beta-adrenoceptor availability after treatment of patients with norepinephrine reuptake inhibitors or tricyclic antidepressants, and differential diagnosis between multiple sclerosis and other brain disorders in an early stage of the disease. No ligands suitable for this purpose are available for human use. In order to prepare a tracer for human studies, we labeled the biologically active enantiomer of the beta-blocker exaprolol with (11)C. Exaprolol has the appropriate lipophilicity (log P + 1.6) for entry of the CNS and is claimed to be a very potent beta-adrenoceptor antagonist. (S)-Desisopropyl-exaprolol was synthesized by reaction of 2-hexylphenol with (S)-glycidyl-nosylate followed by ring opening using ammonia gas. The desisopropyl precursor was reacted with (11)C-acetone in methanol to produce (S)-[(11)C]-exaprolol. Radiochemical purification was performed with RP-HPLC and was followed by Sep-Pak formulation. The labeled product was i.v. injected into male Wistar rats. Brain images were acquired using a microPET Focus 220 and the biodistribution of (11)C was assessed. The radiochemical yield of (S)-[(11)C]-exaprolol was 7% with a total synthesis time of 30 min. Specific activities were >10 GBq/micromol. Brain uptake of the tracer reached a maximum after 15 min. Standardized uptake values were moderate (0.5-0.9) but sufficient for imaging. However, beta-blockade (propranolol, 2.5mg/kg body weight) did not lower tracer uptake in any CNS region and washout from the brain was not accelerated when propranolol was administered 40 min after injection of (S)-[(11)C]-exaprolol. Tracer binding in lung, spleen and erythrocytes was lowered after beta-blockade, but the myocardial uptake of radioactivity was not affected. These data indicate that (S)-[(11)C]-exaprolol is not a suitable beta-adrenoceptor ligand for PET, probably because the in vivo affinity of exaprolol to beta-adrenoceptors is in the nM rather than the sub-nM range. The observed inhibition of tracer uptake in lung, spleen and erythrocytes seems due to an interaction of propranolol with amine transporters rather than beta-adrenoceptors.
Neurochemistry International 52(4-5):729-33. · 2.86 Impact Factor
