Zr-89-Bevacizumab PET Visualizes Disease Manifestations in Patients with von Hippel-Lindau Disease
| Autor: | Alfons H. H. Bongaerts, Wim J. Sluiter, Elisabeth G.E. de Vries, Sophie J. van Asselt, Johan R. de Jong, Thera P. Links, Bernard A. Zonnenberg, Marjolijn N. Lub-de Hooge, Adrienne H. Brouwers, Sjoukje F. Oosting, Julia D.J. Steinberg, Annemiek M E Walenkamp, Eelco W. Hoving, Anouk N A van der Horst-Schrivers |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Male positron emission tomography hemangioblastoma TUMOR-SUPPRESSOR GENE THERAPY chemistry.chemical_compound 0302 clinical medicine RENAL-CELL CARCINOMA Renal cell carcinoma Hemangioblastoma Young adult medicine.diagnostic_test vascular endothelial growth factor Sunitinib Middle Aged Vascular endothelial growth factor Positron emission tomography 030220 oncology & carcinogenesis Female Radiology medicine.drug Adult EXPRESSION medicine.medical_specialty Bevacizumab bevacizumab Antibodies Monoclonal Humanized Sensitivity and Specificity ANTIANGIOGENIC TREATMENT SUNITINIB 03 medical and health sciences Young Adult Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging Von Hippel–Lindau disease Aged Radioisotopes business.industry RETINAL HEMANGIOBLASTOMAS CENTRAL-NERVOUS-SYSTEM Reproducibility of Results von Hippel-Lindau disease NATURAL-HISTORY medicine.disease Image Enhancement 030104 developmental biology chemistry Positron-Emission Tomography ENDOTHELIAL GROWTH-FACTOR Zirconium Radiopharmaceuticals business |
| Zdroj: | Journal of Nuclear Medicine, 57(8), 1244-1250. SOC NUCLEAR MEDICINE INC |
| ISSN: | 1535-5667 0161-5505 |
| Popis: | Patients with von Hippel-Lindau disease (VHL) are at risk to develop multiple tumors. The growth of lesions is unpredictable, and regular surveillance is critical for early treatment to control local damage. Vascular endothelial growth factor A (VEGF-A) produced locally is supposed to play an important role in development of disease manifestations and is a target for antiangiogenic therapy with the monoclonal antibody bevacizumab. We aimed to assess whether VHL manifestations can be visualized with Zr-89-bevacizumab PET and to explore whether Zr-89-bevacizumab PET can differentiate progressive from nonprogressive lesions. Methods: VHL patients with at least 1 measurable hemangioblastoma were eligible. Zr-89-bevacizumab (37 MBq) was administered intravenously 4 d before the scan. Maximum standardized uptake values were calculated. PET scans were fused with routine MRI of the central nervous system and abdominal MRI or CT. Progressive lesions were defined as new lesions, lesions that became symptomatic, and lesions >= 10 mm that increased >= 10% and >= 4 mm on repeated anatomic imaging within 12 mo. Results: Twenty-two patients were enrolled. At baseline, anatomic imaging showed 311 lesions. Zr-89-bevacizumab PET visualized 59 VHL manifestations, 0-17 per patient. The median of maximum standardized uptake values was 8.5 (range, 1.3-35.8). The detection rate for lesions >= 10 mm was 30.8%. Seven additional hotspots without substrate on baseline anatomic imaging were found; 2 were also detected with anatomic imaging during follow-up. Nine of 25 progressive lesions were visible on PET and 27 of 175 nonprogressive lesions, corresponding to a positive predictive value of 25% and a negative predictive value of 90%. SUVmax was similar in progressive and nonprogressive lesions (median, 4.8; range, 0.9-8.9 vs. median, 6.7; range, 1.3-35.8, P = 0.14). Conclusion: VHL manifestations can be visualized with Zr-89-bevacizumab PET with a striking heterogeneity in tracer accumulation. Zr-89-bevacizumab uptake does not predict progression within 12 mo. In one third of the lesions, the drug target VEGF is available and accessible. Zr-89-bevacizumab PET might offer a tool to select VHL patients for anti-VEGF therapy. |
| Databáze: | OpenAIRE |
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