Bromocriptine enhances the uptake of 99mTc-MIBI in patients with hepatocellular carcinoma

Abstract

99mTc-methoxyisobutyl isonitrile (MIBI) is a suitable transport substrate for the multidrug resistance gene prod-uct P-glycoprotein (P-gp) and widely used for tumor imaging. Bromocriptine has been shown to inhibit the ATPase activity and the function of P-gp. We hypothesized that bromocriptine could promote the accumulation of MIBI by inhibiting P-gp activities, a feature that can be taken advantage of for enhancing 99mTc-MIBI imaging. In the cur-rent study, we sought to investigate whether bromocriptine enhanced the uptake of 99mTc-MIBI in hepatocellular carcinoma patients. Sixty primary hepatocellular carcinoma patients received 99mTc-MIBI single photon emission computer tomgraphy (SPECT) prior to surgery. 99mTc-MIBI SPECT was performed 15 and 120 min after injection of 20 mCi 99mTc-MIBI, and early uptake, delayed uptake (L/Nd), and washout rate (L/Nwr) of 99mTc-MIBI were obtained. In addition, a second 99mTc-MIBI SPECT was performed according to the same method 48 h after bromocriptine administration. We found that, prior to bromocriptine administration, significant MIBI uptake in tumor lesions was noted in only 10 (16.7%, 10/60) patients with hepatocellular carcinoma. No significant MIBI uptake was observed in the tumor lesions of the remaining 50 (83.3%, 50/60) hepatocellular carcinoma patients. Following bromocriptine administration, all the patients without apparent MIBI uptake demonstrated significant MIBI uptake on 99mTc-MIBI SPECT (P < 0.05). Our findings indicate that bromocriptine enhances the uptake of 99mTc-MIBI in patients with hepatocellular carcinoma.