Quantification of [ 18 F]afatinib using PET/CT in NSCLC patients: a feasibility study.

Autor: van de Stadt EA; Department of Pulmonology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands. e.vandestadt@amsterdamumc.nl.; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands. e.vandestadt@amsterdamumc.nl., Yaqub M; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands., Lammertsma AA; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands., Poot AJ; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands., Schober PR; Department of Anesthesiology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands., Schuit RC; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands., Smit EF; Department of Pulmonology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.; Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Bahce I; Department of Pulmonology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands., Hendrikse NH; Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.; Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: EJNMMI research [EJNMMI Res] 2020 Aug 17; Vol. 10 (1), pp. 97. Date of Electronic Publication: 2020 Aug 17.
DOI: 10.1186/s13550-020-00684-4
Abstrakt: Introduction: Only a subgroup of non-small cell lung cancer (NSCLC) patients benefit from treatment using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) such as afatinib. Tumour uptake of [ 18 F]afatinib using positron emission tomography (PET) may identify those patients that respond to afatinib therapy. Therefore, the aim of this study was to find the optimal tracer kinetic model for quantification of [ 18 F]afatinib uptake in NSCLC tumours.
Methods: [ 18 F]Afatinib PET scans were performed in 10 NSCLC patients. The first patient was scanned for the purpose of dosimetry. Subsequent patients underwent a 20-min dynamic [ 15 O]H 2 O PET scan (370 MBq) followed by a dynamic [ 18 F]afatinib PET scan (342 ± 24 MBq) of 60 or 90 min. Using the Akaike information criterion (AIC), three pharmacokinetic plasma input models were evaluated with both metabolite-corrected sampler-based input and image-derived (IDIF) input functions in combination with discrete blood samples. Correlation analysis of arterial on-line sampling versus IDIF was performed. In addition, perfusion dependency and simplified measures were assessed.
Results: Ten patients were included. The injected activity of [ 18 F]afatinib was 341 ± 37 MBq. Fifteen tumours could be identified in the field of view of the scanner. Based on AIC, tumour kinetics were best described using an irreversible two-tissue compartment model and a metabolite-corrected sampler-based input function (Akaike 50%). Correlation of plasma-based input functions with metabolite-corrected IDIF was very strong (r 2 = 0.93). The preferred simplified uptake parameter was the tumour-to-blood ratio over the 60- to 90-min time interval (TBR 60-90 ). Tumour uptake of [ 18 F]afatinib was independent of perfusion.
Conclusion: The preferred pharmacokinetic model for quantifying [ 18 F]afatinib uptake in NSCLC tumours was the 2T3K_vb model. TBR 60-90 showed excellent correlation with this model and is the best candidate simplified method.
Trial Registration: https://eudract.ema.europa.eu/ nr 2012-002849-38.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje