A Comparison of Angiogenesis and Glycolytic Imaging in Patients With Clinical Suspected Locally Advanced Breast Cancer

Vatsa, Rakhee; Ashwathanarayana, Abhiram Gopalajois; Singh, Gurpreet; Kavanal, Anwin Joseph; Kumar, Sunil; Rana, Nivedita; Shukla, Jaya; Mittal, Bhagwant Rai

doi:10.1097/rlu.0000000000002647

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…Clinically, Durante et al showed in a limited study of 10 patients that [ 68 Ga]-NODAGA-RGD has a different spatial distribution than [ 18 F]-FDG bringing different tumour information [ 38 ]. Toriihara et al and Vatsa et al each later confirmed this concept in other small studies, comparing [ 18 F]-FDG with [ 18 F]-FPPRGD 2 [ 58 , 59 ]. Guo et al investigated but found no correlation between micro vessel density (a proliferation-related endothelial cell marker that reflects active angiogenesis) and [ 18 F]-FDG uptake using immunohistochemical staining measurements of angiogenesis in NSCLC [ 60 ].…”

Section: Indirect Targeting Of Angiogenesismentioning

confidence: 81%

“…Although PSMA is not expressed in non-prostate tumours, nor in healthy vasculature, expression does occur in endothelial cells of tumour-associated neovasculature [ 86 ]. Two excellent reviews of PSMA-based imaging in non-prostate imaging have been recently published [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ], but we would like to briefly present the findings regarding angiogenesis here. The functional role of PSMA in angiogenesis is not clear at this moment, nor is PSMA a requirement for tumour-associated neovascularisation—but PSMA expression is associated to tumours that critically depend on angiogenesis.…”

Section: Indirect Targeting Of Angiogenesismentioning

confidence: 99%

“…The question remains which RGD peptide is the optimal choice. Both 18 F, 68 Ga and 99m Tc labelled tracers have shown good biodistribution and pharmacokinetics as well as tumour uptake in a variety of tumours [ 58 , 59 , 129 , 143 , 144 , 145 ]. The added value compared to [ 18 F]-FDG is now emerging, especially in the field of head and neck tumours [ 146 , 147 ], but which tracer that should be integrated into daily clinical routine remains an open question.…”

Section: Direct Targeting Of Angiogenesismentioning

confidence: 99%

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Molecular Imaging of Angiogenesis in Oncology: Current Preclinical and Clinical Status

Florea

Mottaghy

Bauwens

2021

IJMS

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Angiogenesis is an active process, regulating new vessel growth, and is crucial for the survival and growth of tumours next to other complex factors in the tumour microenvironment. We present possible molecular imaging approaches for tumour vascularisation and vitality, focusing on radiopharmaceuticals (tracers). Molecular imaging in general has become an integrated part of cancer therapy, by bringing relevant insights on tumour angiogenic status. After a structured PubMed search, the resulting publication list was screened for oncology related publications in animals and humans, disregarding any cardiovascular findings. The tracers identified can be subdivided into direct targeting of angiogenesis (i.e., vascular endothelial growth factor, laminin, and fibronectin) and indirect targeting (i.e., glucose metabolism, hypoxia, and matrix metallo-proteases, PSMA). Presenting pre-clinical and clinical data of most tracers proposed in the literature, the indirect targeting agents are not 1:1 correlated with angiogenesis factors but do have a strong prognostic power in a clinical setting, while direct targeting agents show most potential and specificity for assessing tumour vascularisation and vitality. Within the direct agents, the combination of multiple targeting tracers into one agent (multimers) seems most promising. This review demonstrates the present clinical applicability of indirect agents, but also the need for more extensive research in the field of direct targeting of angiogenesis in oncology. Although there is currently no direct tracer that can be singled out, the RGD tracer family seems to show the highest potential therefore we expect one of them to enter the clinical routine.

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Section: Indirect Targeting Of Angiogenesismentioning

confidence: 81%

Section: Indirect Targeting Of Angiogenesismentioning

confidence: 99%

Section: Direct Targeting Of Angiogenesismentioning

confidence: 99%

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Molecular Imaging of Angiogenesis in Oncology: Current Preclinical and Clinical Status

Florea

Mottaghy

Bauwens

2021

IJMS

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“…18 F-AH111585 tracer uptake either homogeneously distributed in tumors or appearing within the tumor rim in metastatic breast cancer patients, which was consistent with the general principles of angiogenesis localization within the outer zones of breast tumors, where viable tumors exist (129)(130)(131)(132). Vatsa et al reported the results of 68 Ga-DOTA-RGD2 PET/CT in patients with locally advanced breast carcinoma (LABC) and found both 68 Ga-DOTA-RGD2 and 18 F-FDG were similarly able to diagnose primary and metastatic lymph nodes, and RGD-based imaging showed additional value for distinguishing nonspecific 18 F-FDG uptake due to an infectious or inflammatory etiology (133). The sensitivity and specificity of 18 F-FPPRGD2 PET for identifying either breast lesions or metastatic lesions were higher than those for 18 F-FDG PET/CT (95.7% vs. 87.0%, and 100% vs. 57.1%) (63).…”

Section: Breast Cancermentioning

confidence: 99%

“…However, in HER2 (-) and ER(+) breast cancer lesions, 18 F-Alfatide II uptake was higher than 18 F-FDG uptake (88). It is worthy noting that RGD PET may neglect the distant metastasis in liver; for example, Kumar et al found that 68 Ga-DOTA-RGD was not retained in liver metastases in 9 patients (16%) that were discovered with 18 F-FDG imaging (119,133). The high background activity of liver regions may contribute to this phenomenon (60).…”

Section: Breast Cancermentioning

confidence: 99%

Preliminary Clinical Application of RGD-Containing Peptides as PET Radiotracers for Imaging Tumors

Chen

et al. 2022

Front. Oncol.

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Angiogenesis is a common feature of many physiological processes and pathological conditions. RGD-containing peptides can strongly bind to integrin αvβ3 expressed on endothelial cells in neovessels and several tumor cells with high specificity, making them promising molecular agents for imaging angiogenesis. Although studies of RGD-containing peptides combined with radionuclides, namely, 18F, 64Cu, and 68Ga for positron emission tomography (PET) imaging have shown high spatial resolution and accurate quantification of tracer uptake, only a few of these radiotracers have been successfully translated into clinical use. This review summarizes the RGD-based tracers in terms of accumulation in tumors and adjacent tissues, and comparison with traditional 18F-fluorodeoxyglucose (FDG) imaging. The value of RGD-based tracers for diagnosis, differential diagnosis, tumor subvolume delineation, and therapeutic response prediction is mainly discussed. Very low RGD accumulation, in contrast to high FDG metabolism, was found in normal brain tissue, indicating that RGD-based imaging provides an excellent tumor-to-background ratio for improved brain tumor imaging. However, the intensity of the RGD-based tracers is much higher than FDG in normal liver tissue, which could lead to underestimation of primary or metastatic lesions in liver. In multiple studies, RGD-based imaging successfully realized the diagnosis and differential diagnosis of solid tumors and also the prediction of chemoradiotherapy response, providing complementary rather than similar information relative to FDG imaging. Of most interest, baseline RGD uptake values can not only be used to predict the tumor efficacy of antiangiogenic therapy, but also to monitor the occurrence of adverse events in normal organs. This unique dual predictive value in antiangiogenic therapy may be better than that of FDG-based imaging.

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Clinical evaluation of kit based Tc-99m-HYNIC-RGD2 for imaging angiogenesis in breast carcinoma patients

Vatsa

Madaan

Chakraborty

et al. 2020

Nuclear Medicine Communications

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Background Radiolabeled RGD peptide can be used for noninvasive in vivo imaging of αvβ3 integrin receptors leading to early detection of tumor cells and hence improving the clinical outcomes. In the present study single vial kit based HYNIC RGD2 was radiolabeled with Tc-99m and evaluated in patients with breast carcinoma. Methods Radiolabeling was performed via bifunctional chelator method. Tc-99m 1110–2960 MBq (30–80 mCi) was added to the HYNIC-RGD2 vial. The reaction mixture was heated for 20 minutes at 100°C. After performing the quality checks, whole-body planar imaging was performed in 20 patients at 2–2.5 h post i.v. injection of 555–740 MBq (15–20 mCi) of the radiotracer. Results Radiolabeling yield of ≥98% was observed in all the formulations. Quality control tests indicated the suitability of radiopharmaceutical for intravenous administration. Physiological uptake of Tc-99m HYNIC-RGD2 was observed in the nasopharynx, salivary glands, liver, spleen, and intestine. Good uptake of radiotracer was observed in breast lesions of 18 patients. Two patients were observed to be negative. Increased uptake was also seen in metastatic sites in two patients and in lymph nodes in three patients. Scintigraphy findings were in corroboration with pathological observations. Conclusion The single vial cold kit based radiolabeling of Tc-99m HYNIC-RGD2 is facile leading to its easy availability. Tc-99m HYNIC-RGD2 is a promising radiopharmaceutical which can be used for the molecular imaging of angiogenesis in breast carcinoma patients.

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A Comparison of Angiogenesis and Glycolytic Imaging in Patients With Clinical Suspected Locally Advanced Breast Cancer

Cited by 3 publications

References 11 publications

Molecular Imaging of Angiogenesis in Oncology: Current Preclinical and Clinical Status

Molecular Imaging of Angiogenesis in Oncology: Current Preclinical and Clinical Status

Preliminary Clinical Application of RGD-Containing Peptides as PET Radiotracers for Imaging Tumors

Clinical evaluation of kit based Tc-99m-HYNIC-RGD2 for imaging angiogenesis in breast carcinoma patients

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