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Dual time point imaging fluorine-18 flourodeoxyglucose positron emission tomography for evaluation of large loco-regional recurrences of breast cancer treated with electrochemotherapy.

Matthiessen LW, Johannesen HH, Skougaard K, Gehl J, Hendel HW - Radiol Oncol (2013)

Bottom Line: Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment.The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease.To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal.

View Article: PubMed Central - PubMed

Affiliation: Center for Experimental Drug and Gene Electrotransfer (C EDGE), Department of Oncology, Copenhagen University Hospital Herlev, Copenhagen University Hospital Herlev, Herlev, Denmark.

ABSTRACT

Background: Electrochemotherapy is a local anticancer treatment very efficient for treatment of small cutaneous metastases. The method is now being investigated for large cutaneous recurrences of breast cancer that are often confluent masses of malignant tumour with various degrees of inflammation. To this end 18-Flourine-Flourodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could be a method for response evaluation. However, a standard FDG-PET/CT scan cannot differentiate inflammatory tissue from malignant tissue. Dual point time imaging (DTPI) FDG-PET has the potential of doing so. The purpose of this study was to investigate if DTPI FDG-PET/CT could assess response to electrochemotherapy and to assess the optimal timing of imaging.

Patients and methods: Within a phase II clinical trial 11 patients with cutaneous recurrences had FDG-PET/CT scans at three time points: 60 min, 120 min and 180 min after FDG injection. The scans were performed before and 3 weeks after electrochemotherapy.

Results: A significant reduction in maximum standard uptake value at 60 min post injection was seen after treatment. Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment. The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease. To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal.

Conclusions: The present study shows that FDG-PET/CT 60 and 180 min after tracer injection is a promising tool for response evaluation of cutaneous recurrences of breast cancer treated with electrochemotherapy.

No MeSH data available.


Related in: MedlinePlus

Change in SUVmax over time in target lesions and background. There was significant increase in mean SUVmax over time in target lesions before treatment wheras the mean SUVmax in target lesions after treatment stabilized at 120 min after FDG injection. Mean SUVmax in background (measused in the aortic arch) did not increase over time.
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f2-rado-47-04-358: Change in SUVmax over time in target lesions and background. There was significant increase in mean SUVmax over time in target lesions before treatment wheras the mean SUVmax in target lesions after treatment stabilized at 120 min after FDG injection. Mean SUVmax in background (measused in the aortic arch) did not increase over time.

Mentions: At the 60 min p.i. scans CMR was observed in 2 lesions, PMR in 7 lesions, SMD in 6 lesions, and PMD in 1 lesion. The corresponding responses observed at the 120 min p.i. scans were CMR in 2 lesions, PMR in 7 lesions, SMD in 6 lesions, and PMD in 1 lesion. Observed responses at the 180 min p.i. was CMR in 2 lesions, PMR in 9 lesions, SMD in 3 lesions, and PMD in 1 lesion (Table 1). One patient did not have the baseline 180 min post tracer injection scan and was therefore not evaluated at 180 min p.i. The changes in SUVmax over time are illustrated in Figure 2 and an example is given in Figure 1.


Dual time point imaging fluorine-18 flourodeoxyglucose positron emission tomography for evaluation of large loco-regional recurrences of breast cancer treated with electrochemotherapy.

Matthiessen LW, Johannesen HH, Skougaard K, Gehl J, Hendel HW - Radiol Oncol (2013)

Change in SUVmax over time in target lesions and background. There was significant increase in mean SUVmax over time in target lesions before treatment wheras the mean SUVmax in target lesions after treatment stabilized at 120 min after FDG injection. Mean SUVmax in background (measused in the aortic arch) did not increase over time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3814280&req=5

f2-rado-47-04-358: Change in SUVmax over time in target lesions and background. There was significant increase in mean SUVmax over time in target lesions before treatment wheras the mean SUVmax in target lesions after treatment stabilized at 120 min after FDG injection. Mean SUVmax in background (measused in the aortic arch) did not increase over time.
Mentions: At the 60 min p.i. scans CMR was observed in 2 lesions, PMR in 7 lesions, SMD in 6 lesions, and PMD in 1 lesion. The corresponding responses observed at the 120 min p.i. scans were CMR in 2 lesions, PMR in 7 lesions, SMD in 6 lesions, and PMD in 1 lesion. Observed responses at the 180 min p.i. was CMR in 2 lesions, PMR in 9 lesions, SMD in 3 lesions, and PMD in 1 lesion (Table 1). One patient did not have the baseline 180 min post tracer injection scan and was therefore not evaluated at 180 min p.i. The changes in SUVmax over time are illustrated in Figure 2 and an example is given in Figure 1.

Bottom Line: Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment.The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease.To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal.

View Article: PubMed Central - PubMed

Affiliation: Center for Experimental Drug and Gene Electrotransfer (C EDGE), Department of Oncology, Copenhagen University Hospital Herlev, Copenhagen University Hospital Herlev, Herlev, Denmark.

ABSTRACT

Background: Electrochemotherapy is a local anticancer treatment very efficient for treatment of small cutaneous metastases. The method is now being investigated for large cutaneous recurrences of breast cancer that are often confluent masses of malignant tumour with various degrees of inflammation. To this end 18-Flourine-Flourodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could be a method for response evaluation. However, a standard FDG-PET/CT scan cannot differentiate inflammatory tissue from malignant tissue. Dual point time imaging (DTPI) FDG-PET has the potential of doing so. The purpose of this study was to investigate if DTPI FDG-PET/CT could assess response to electrochemotherapy and to assess the optimal timing of imaging.

Patients and methods: Within a phase II clinical trial 11 patients with cutaneous recurrences had FDG-PET/CT scans at three time points: 60 min, 120 min and 180 min after FDG injection. The scans were performed before and 3 weeks after electrochemotherapy.

Results: A significant reduction in maximum standard uptake value at 60 min post injection was seen after treatment. Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment. The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease. To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal.

Conclusions: The present study shows that FDG-PET/CT 60 and 180 min after tracer injection is a promising tool for response evaluation of cutaneous recurrences of breast cancer treated with electrochemotherapy.

No MeSH data available.


Related in: MedlinePlus