emerging technologies, challenges and opportunities: role ...€¦ · 18fdg 18fdg-6p hif1a...
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Emerging Technologies, Challenges and Opportunities:
Role of Imaging in Breast Cancer
Homer A. Macapinlac, MD
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Molecular Imaging• Visualization, characterization and quantification of biologic processes taking place at the cellular and sub-cellular levels
• Nuclear Medicine Tracers: PET, SPECT • X rays: CT• Sound: US• Light: Optical bioluminesence/fluoresence• Magnetism: MRI
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Bone Scan
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GLUTGLUT--11
K3
K4
Hexokinase
Cancer Cell
Glucose-6-phosphatase
18FDG-1-P
Glycogen
18F-fru-6-P
Glycolysis
18FDG-6-phospho-glucono-lactone
HMPshunt
18FDG
Vascular
K1
K2
18FDG 18FDG-6P
HIF1a(hypoxia)
Angiogenesis, bFGF,PDGF-BB, EGFR
Macheda, J Cellular Physiology 2005; 202:654-662Bos Histopathology 2005;46:31-36
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18FDG β+β-p
γ
γPET/CT
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Reduction in FDG retention isAssociatedwith a Pathologic Response
and Improved Survival
Breast Cancer
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FLT PET at 1 week post Chemotherapy: in Breast Cancer
Kenny L , et. al. Eur J Nucl Med Mol Imaging. 2007 Sep;34(9):1339-47.
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(RGD) peptide radioligand 18F-AH111585 in Breast Cancer.Kenny LM et.al.J Nucl Med. 2008 Jun;49(6):879-86.
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Fluoroestradiol PET Her2 PET
JCO June 20, 2006 vol. 24 no. 18 2793-2799 JCO July 20, 2010 vol. 28 no. 21 e355-e356