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J Nucl Med. 2008; 49 (Supplement 1):324P
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Oncology-Basic Science: Therapy, Metrics & Intervention

Therapy, Metrics & Intervention Posters

Estimation of tumor blood flow using Rb-82 dynamic PET (dPET) and perfusion CT (pCT) in the assessment of anti-angiogenic therapy: A pilot study

Georges El Fakhri1, Victor Gerbaudo1, John Millstine2, Giraldo Kato2, Mitesh Borad3, Raoul Tibes3, Scott Britz-Cunningham1 and Ronald Korn2

1 Radiology, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts; 2 Radiology, Scottsdale Medical Imaging, Scottsdale, Arizona; 3 Scottsdale Clinical Research Institute, Scottsdale, Arizona

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Objectives: PET-CT has great potential in monitoring drugs pharmacokinetics and pharmacodynamics in anti-angiogenic therapy. We explore the feasibility of using dPET and pCT to assess tumor blood flow (TBF) in this context.

Methods: Three patients with unresectable non small cell lung carcinoma (stage 3b) and colorectal carcinoma (stage 4) received 1 cycle of an anti-angiogenic drug therapy. Immediately before and 7-14 days after therapy, patients were injected with 50mCi of Rb-82 and imaged dynamically for 6 min using PET/CT. Ventricular input functions and TBF (ml/g/min) were computed using generalized factor analysis of dynamic sequences and 2-compartment kinetic modeling. pCT was also performed and TBF computed in contiguous slices (9.6mm tichk) centered on the lesion.

Results: TBF measured with dPET and pCT followed the same trend: Pat1 had 26% reduction of TBF on dPET (10% reduction on pCT) and an unconfirmed partial response. In pat2, there was 15% reduction of TBF on dPET (38% on pCT) and the patient’s disease remained stable. In pat3, there was a TBF increase of 21% on PET (45% on pCT) and the patient did not respond to therapy. Our results show reasonable correlation between pCT and dPET perfusion estimates.

Conclusions: dPET and pCT have an important potential role in early assessment of response to anti-angiogenic therapy. dPET and pCT derived tumor blood flows follow similar trends before and after therapy, with dPET having the advantage of estimating TBF within the entire tumor, rather than sampling a small region with pCT. Further studies are warranted.

Research Support: NIH (RO1-EB005876), Bracco Diagnostics





This Article
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Google Scholar
Right arrow Articles by El Fakhri, G.
Right arrow Articles by Korn, R.
PubMed
Right arrow Articles by El Fakhri, G.
Right arrow Articles by Korn, R.