Abstract
Positron Emission Tomography-Computed Tomography (PET-CT) is routinely used for staging and monitoring of human cancer patients and is becoming increasingly available in veterinary medicine. In this study, 18-fluorodeoxyglucose (18FDG)-PET-CT was used in dogs with naturally occurring splenic hemangiosarcoma (HSA) to assess its utility as a staging and monitoring modality as compared to standard radiography and ultrasonography. Nine dogs with stage-2 HSA underwent 18FDG-PET-CT following splenectomy and prior to commencement of chemotherapy. Routine staging (thoracic radiography and abdominal ultrasonography) was performed prior to 18FDG-PET-CT in all dogs. When abnormalities not identified on routine tests were noted on 18FDG-PET-CT, owners were given the option to repeat a PET-CT following treatment with eBAT. A PET-CT scan was repeated on Day 21 in three dogs. Abnormalities not observed on conventional staging tools, and most consistent with malignant disease based on location, appearance, and outcome, were detected in two dogs and included a right atrial mass and a hepatic nodule, respectively. These lesions were larger and had higher metabolic activity on the second scans. 18FDG-PET-CT has potential to provide important prognostic information and influence treatment recommendations for dogs with stage-2 HSA. Additional studies will be needed to precisely define the value of this imaging tool for staging and therapy monitoring in dogs with this and other cancers.
Highlights
Positron Emission Tomography-Computed Tomography (PET-CT) is commonly used in human cancer patients to non-invasively diagnose, prognosticate, evaluate therapy-induced changes in tumor metabolism, and monitor response to antineoplastic therapy [1,2,3]
FDG extravasates into the interstitium, where it is internalized via facilitative glucose transporters (GLUT), which are present on all cell membranes and especially enhanced on tumor cell membranes
We previously showed that canine HSA tumor-initiating cells express epidermal growth factor receptors (EGFR) and urokinase plasminogen activator receptors, and that these cells are effectively killed by a bispecific EGF-urokinase angiotoxin designed to target EGFR and uPAR simultaneously [24]
Summary
Positron Emission Tomography-Computed Tomography (PET-CT) is commonly used in human cancer patients to non-invasively diagnose, prognosticate, evaluate therapy-induced changes in tumor metabolism, and monitor response to antineoplastic therapy [1,2,3]. The clinical application of 18F-fluoro-2-deoxyglucose (18FDG)-PET-CT as a staging and monitoring tool in veterinary oncology has been limited by the availability and cost of necessary facilities and equipment [4,5,6,7]. Anaerobic glycolysis is a relatively inefficient process, resulting in a strongly increased demand for glucose in cancer cells, which can be visualized with FDG. FDG is phosphorylated into FDG-6-phosphate, which, unlike glucose, is trapped inside the cell and cannot enter the glycolysis pathway [2,3,4,5,6,7,8]
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