18F-Fluoroestradiol Tumor Uptake Is Heterogeneous and Influenced by Site of Metastasis in Breast Cancer Patients

被引:48
作者
Nienhuis, Hilde H. [1 ]
van Kruchten, Michel [1 ]
Elias, Sjoerd G. [2 ]
Glaudemans, Andor W. J. M. [3 ]
de Vries, Erik F. J. [3 ]
Bongaerts, Alfons H. H. [3 ]
Schroeder, Carolien P. [1 ]
de Vries, Elisabeth G. E. [1 ]
Hospers, Geke A. P. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands
[2] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol, Utrecht, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Nucl Med & Mol Imaging, Groningen, Netherlands
基金
欧洲研究理事会;
关键词
breast cancer; estrogen receptor; F-18-fluoroestradiol PET; tumor heterogeneity; tumor microenvironment; POSITRON-EMISSION-TOMOGRAPHY; ESTROGEN-RECEPTOR BINDING; IN-VIVO; PET; THERAPY; FUTURE; PROGESTERONE; RESISTANCE; EVOLUTION; ANDROGEN;
D O I
10.2967/jnumed.117.198846
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Heterogeneity of estrogen receptor (ER) expression in breast cancer is recognized. However, knowledge about varying expression across metastases and surrounding normal tissue in patients is scarce. We therefore analyzed 16 alpha-F-18-fluoro-17 beta-estradiol (F-18-FES) PET to assess ER expression heterogeneity. Methods: F-18-FES PET on accredited PET/CT camera systems performed in patients with ER-positive metastatic breast cancer November 2009-December 2014 was analyzed. Lesions with an SUVmax 1.5 or more were considered ER-positive, but liver lesions were excluded given high background liver signal. CT lesions with a diameter 10 mm or more were included. We used multilevel linear-mixed models to evaluate determinants of F-18-FES uptake. Cluster analysis was performed with different imaging features per patient as input variables. Results: In 91 patients, 1,617 metastases in bone (78%), lymph node (15%), lung (4%), or liver (2%) were identified by CT (11.2%), PET (56.6%), or both (32.2%). Median tumor uptake varied greatly between patients (SUVmax, 0.54-14.21). F-18-FES uptake in bone metastases was higher than in lymph node and lung metastases (geometric mean SUVmax, 2.61 [95% confidence interval (CI), 2.31-2.94] vs. 2.29 [95% CI, 2.00-2.61; P < 0.001] vs. 2.23 [95% CI, 1.88-2.61; P = 0.021]), respectively. Cluster analysis identified 3 subgroups of patients characterized by particular metastatic sites and F-18-FES PET/CT features. SUVmax in surrounding normal tissue, highest in the bones, varied per patient (range, 0.7-3.3). Conclusion: F-18-FES uptake is heterogeneous in tumor and normal tissue and influenced by anatomic site. Different patterns can be distinguished, possibly identifying biologically relevant ER-positive metastatic breast cancer patient subgroups.
引用
收藏
页码:1212 / 1218
页数:7
相关论文
共 33 条
[1]   Toward understanding and exploiting tumor heterogeneity [J].
Alizadeh, Ash A. ;
Aranda, Victoria ;
Bardelli, Alberto ;
Blanpain, Cedric ;
Bock, Christoph ;
Borowski, Christine ;
Caldas, Carlos ;
Califano, Andrea ;
Doherty, Michael ;
Elsner, Markus ;
Esteller, Manel ;
Fitzgerald, Rebecca ;
Korbel, Jan O. ;
Lichter, Peter ;
Mason, Christopher E. ;
Navin, Nicholas ;
Pe'er, Dana ;
Polyak, Kornelia ;
Roberts, Charles W. M. ;
Siu, Lillian ;
Snyder, Alexandra ;
Stower, Hannah ;
Swanton, Charles ;
Verhaak, Roel G. W. ;
Zenklusen, Jean C. ;
Zuber, Johannes ;
Zucman-Rossi, Jessica .
NATURE MEDICINE, 2015, 21 (08) :846-853
[2]  
ALLEGRA JC, 1979, CANCER RES, V39, P1447
[3]   Prospective Study Evaluating the Impact of Tissue Confirmation of Metastatic Disease in Patients With Breast Cancer [J].
Amir, Eitan ;
Miller, Naomi ;
Geddie, William ;
Freedman, Orit ;
Kassam, Farrah ;
Simmons, Christine ;
Oldfield, Maria ;
Dranitsaris, George ;
Tomlinson, George ;
Laupacis, Andreas ;
Tannock, Ian F. ;
Clemons, Mark .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (06) :587-592
[4]   Incidence of Breast Cancer in the United States: Current and Future Trends [J].
Anderson, William F. ;
Katki, Hormuzd A. ;
Rosenberg, Philip S. .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2011, 103 (18) :1397-1402
[5]   A meta-analysis of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 discordance between primary breast cancer and metastases [J].
Aurilio, Gaetano ;
Disalvatore, Davide ;
Pruneri, Giancarlo ;
Bagnardi, Vincenzo ;
Viale, Giuseppe ;
Curigliano, Giuseppe ;
Adamoli, Laura ;
Munzone, Elisabetta ;
Sciandivasci, Angela ;
De Vita, Fernando ;
Goldhirsch, Aron ;
Nole, Franco .
EUROPEAN JOURNAL OF CANCER, 2014, 50 (02) :277-289
[6]   FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0 [J].
Boellaard, Ronald ;
Delgado-Bolton, Roberto ;
Oyen, Wim J. G. ;
Giammarile, Francesco ;
Tatsch, Klaus ;
Eschner, Wolfgang ;
Verzijlbergen, Fred J. ;
Barrington, Sally F. ;
Pike, Lucy C. ;
Weber, Wolfgang A. ;
Stroobants, Sigrid ;
Delbeke, Dominique ;
Donohoe, Kevin J. ;
Holbrook, Scott ;
Graham, Michael M. ;
Testanera, Giorgio ;
Hoekstra, Otto S. ;
Zijlstra, Josee ;
Visser, Eric ;
Hoekstra, Corneline J. ;
Pruim, Jan ;
Willemsen, Antoon ;
Arends, Bertjan ;
Kotzerke, Joerg ;
Bockisch, Andreas ;
Beyer, Thomas ;
Chiti, Arturo ;
Krause, Bernd J. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2015, 42 (02) :328-354
[7]   Tumour heterogeneity and the evolution of polyclonal drug resistance [J].
Burrell, Rebecca A. ;
Swanton, Charles .
MOLECULAR ONCOLOGY, 2014, 8 (06) :1095-1111
[8]  
Charrad M, 2014, J STAT SOFTW, V61, P1
[9]   PET-based estradiol challenge as a predictive biomarker of response to endocrine therapy in women with estrogen-receptor-positive breast cancer [J].
Dehdashti, Farrokh ;
Mortimer, Joanne E. ;
Trinkaus, Kathryn ;
Naughton, Michael J. ;
Ellis, Matthew ;
Katzenellenbogen, John A. ;
Welch, Michael J. ;
Siegel, Barry A. .
BREAST CANCER RESEARCH AND TREATMENT, 2009, 113 (03) :509-517
[10]  
Ferlay J., 2013, GLOBOCAN 2012 CANC I