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J Nucl Med. 2018 Apr;59(4):612-615. doi: 10.2967/jnumed.117.197897. Epub 2017 Aug 17.

Multiregional Tumor Drug-Uptake Imaging by PET and Microvascular Morphology in End-Stage Diffuse Intrinsic Pontine Glioma.

Author information

1
Division of Oncology/Haematology, Department of Pediatrics, VUmc, Amsterdam, The Netherlands s.veldhuijzen@vumc.nl.
2
Neuro-Oncology Research Group, Cancer Center Amsterdam, VUmc, Amsterdam, The Netherlands.
3
Division of Oncology/Haematology, Department of Pediatrics, VUmc, Amsterdam, The Netherlands.
4
Department of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
5
Department of Pathology, VUmc, Amsterdam, The Netherlands.
6
Department of Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; and.
7
Department of Pediatrics, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.

Abstract

Inadequate tumor uptake of the vascular endothelial growth factor antibody bevacizumab could explain lack of effect in diffuse intrinsic pontine glioma. Methods: By combining data from a PET imaging study using 89Zr-labeled bevacizumab and an autopsy study, a 1-on-1 analysis of multiregional in vivo and ex vivo 89Zr-bevacizumab uptake, tumor histology, and vascular morphology in a diffuse intrinsic pontine glioma patient was performed. Results: In vivo 89Zr-bevacizumab measurements showed heterogeneity between lesions. Additional ex vivo measurements and immunohistochemistry of cervicomedullary metastasis samples showed uptake to be highest in the area with marked microvascular proliferation. In the primary pontine tumor, all samples showed similar vascular morphology. Other histologic features were similar between the samples studied. Conclusion: In vivo 89Zr-bevacizumab PET serves to identify heterogeneous uptake between tumor lesions, whereas subcentimeter intralesional heterogeneity could be identified only by ex vivo measurements. 89Zr-bevacizumab uptake is enhanced by vascular proliferation, although our results suggest it is not the only determinant of intralesional uptake heterogeneity.

KEYWORDS:

89Zr-bevacizumab; PET; VEGF; brain stem neoplasm; microvascular morphology

PMID:
28818988
DOI:
10.2967/jnumed.117.197897

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