Imaging of Highly Malignant Osteosarcoma with Iodine-123-Vascular Endothelial Growth Factor

Abstract

Objective: Vascular endothelial growth factor (VEGF) is an important angiogenic factor, and its receptors have been shown to be overexpressed in various human carcinomas. In this study, we investigated the role of scanning with iodine-123 (¹²³I)-labelled VEGF₁₆₅ in patients with highly malignant osteosarcoma. Methods: Two patients (a 15-year-old female and a 14-year-old male) with osteosarcoma were injected with 140 MBq [<130 pmol (<5 µg) VEGF₁₆₅ per patient] of ¹²³I-VEGF₁₆₅. Dynamic acquisition was initiated immediately after administration and carried out until 30 min after injection. Whole-body images were done in anterior and posterior views at various time points. All patients underwent single-photon emission tomography imaging. Results:¹²³I-VEGF₁₆₅ scans were positive in these patients. Sequential images clearly showed increased ¹²³I-VEGF₁₆₅ activity in osteosarcoma lesions. The tumour lesions were still visualized in whole-body images and single-photon emission tomography examinations 2 h after injection. Intravenous injection of ¹²³I-VEGF₁₆₅ did not cause any side effects. Conclusion: Our results suggest that ¹²³I-VEGF₁₆₅ receptor scintigraphy may be useful for the visualization of highly malignant osteosarcoma and/or metastasis and the angiogenic activity of the tumour.