Abstract
Background18F-fluciclovine is a synthetic amino acid positron emission tomography (PET) radiotracer that is approved for use in prostate cancer. In this clinical study, we characterised the kinetic model best describing the uptake of 18F-fluciclovine in breast cancer and assessed differences in tracer kinetics and static parameters for different breast cancer receptor subtypes and tumour grades.MethodsThirty-nine patients with pathologically proven breast cancer underwent 20-min dynamic PET/computed tomography imaging following the administration of 18F-fluciclovine. Uptake into primary breast tumours was evaluated using one- and two-tissue reversible compartmental kinetic models and static parameters.ResultsA reversible one-tissue compartment model was shown to best describe tracer uptake in breast cancer. No significant differences were seen in kinetic or static parameters for different tumour receptor subtypes or grades. Kinetic and static parameters showed a good correlation.Conclusions18F-fluciclovine has potential in the imaging of primary breast cancer, but kinetic analysis may not have additional value over static measures of tracer uptake.Clinical Trial RegistrationNCT03036943.
Highlights
18F-fluciclovine is a synthetic amino acid positron emission tomography (PET) radiotracer that is approved for use in prostate cancer
Amino acid uptake is upregulated in breast cancer [4], synthetic amino acid analogues may be a useful tool in molecular imaging of this disease [5]. 18F-Fluciclovine is a synthetic amino acid PET radiotracer already licensed for use in patients with biochemically recurrent prostate cancer [6, 7], and its utility for imaging breast cancer is currently under investigation [5, 8, 9]
Kinetic modelling of the dynamic PET images demonstrated that 18F-fluciclovine uptake in breast cancer is best described by a reversible one-tissue compartment model
Summary
18F-fluciclovine is a synthetic amino acid positron emission tomography (PET) radiotracer that is approved for use in prostate cancer In this clinical study, we characterised the kinetic model best describing the uptake of 18F-fluciclovine in breast cancer and assessed differences in tracer kinetics and static parameters for different breast cancer receptor subtypes and tumour grades. Molecular imaging of breast cancer through the use of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) is commonly used for tumour staging and assessment of therapy response. It is limited by its poor differentiation of malignant and benign lesions [1], varied sensitivity and inability to pick up certain histologic subtypes [2]. We assessed whether there was a relationship between 18F-fluciclovine tumour uptake and three surrogate markers of clinical outcome in breast cancer that have previously been shown to correlate with breast tumour FDG uptake: grade, tumour Ki-67
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