Zr-89- Bevacizumab PET Imaging in Primary Breast Cancer

Sietske B. M. Gaykema, Adrienne H. Brouwers, Marjolijn N. Lub-de Hooge, Rick G. Pleijhuis, Hetty Timmer-Bosscha, Linda Pot, Gooitzen M. van Dam, Sibylle B. van der Meulen, Johan R. de Jong, Joost Bart, Jakob de Vries, Liesbeth Jansen, Elisabeth G. E. de Vries, Carolien P. Schroder*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

135 Citations (Scopus)

Abstract

UNLABELLED: Vascular endothelial growth factor (VEGF)-A is overexpressed in most malignant and premalignant breast lesions. VEGF-A can be visualized noninvasively with PET imaging and using the tracer (89)Zr-labeled bevacizumab. In this clinical feasibility study, we assessed whether VEGF-A in primary breast cancer can be visualized by (89)Zr-bevacizumab PET.

METHODS: Before surgery, breast cancer patients underwent a PET/CT scan of the breasts and axillary regions 4 d after intravenous administration of 37 MBq of (89)Zr-bevacizumab per 5 mg. PET images were compared with standard imaging modalities. (89)Zr-bevacizumab uptake was quantified as the maximum standardized uptake value (SUV max). VEGF-A levels in tumor and normal breast tissues were assessed with enzyme-linked immunosorbent assay. Data are presented as mean ± SD.

RESULTS: Twenty-five of 26 breast tumors (mean size ± SD, 25.1 ± 19.8 mm; range, 4-80 mm) in 23 patients were visualized. SUV max was higher in tumors (1.85 ± 1.22; range, 0.52-5.64) than in normal breasts (0.59 ± 0.37; range, 0.27-1.69; P < 0.001). The only tumor not detected on PET was 10 mm in diameter. Lymph node metastases were present in 10 axillary regions; 4 could be detected with PET (SUV max, 2.66 ± 2.03; range, 1.32-5.68). VEGF-A levels in the 17 assessable tumors were higher than in normal breast tissue in all cases (VEGF-A/mg protein, 184 ± 169 pg vs. 10 ± 21 pg; P = 0.001), whereas (89)Zr-bevacizumab tumor uptake correlated with VEGF-A tumor levels (r = 0.49).

CONCLUSION: VEGF-A in primary breast cancer can be visualized by means of (89)Zr-bevacizumab PET.

Original languageEnglish
Pages (from-to)1014-1018
Number of pages5
JournalJournal of Nuclear Medicine
Volume54
Issue number7
DOIs
Publication statusPublished - 1-Jul-2013

Keywords

  • breast cancer
  • VEGF-A
  • Zr-89-bevacizumab PET
  • early detection
  • ENDOTHELIAL GROWTH-FACTOR
  • RADIATION-EXPOSURE
  • FDG-PET
  • VEGF
  • ANGIOGENESIS
  • CHEMOTHERAPY
  • TRIAL

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