Oxygen-15 positron-emission tomography for predicting selective delivery of a chemotherapeutic agent to hepatic cancers during angiotensin II-induced hypertension.
OBJECTIVE
Selective drug delivery is important for successful chemotherapy. In patients with hepatic cancer, we used (15)O-carbon dioxide (steady-state) and (15)O-water (dynamic) positron emission tomography (PET) to evaluate changes in blood flow induced by angiotensin (AT) II in the liver parenchyma, hepatic tumors, and spleen.


METHODS
The study group comprised 13 patients, 6 with hepatic metastasis and 7 with hepatocellular carcinoma. PET was performed before and during AT II administration to induce hypertension.


RESULTS
Steady-state PET images showed a preferential increase in blood flow to hepatic tumor compared with liver parenchyma during hypertension. In dynamic PET, tumor blood flow was maintained during induced hypertension while hepatic arterial blood flow, portal blood flow, total hepatic blood flow, and splenic blood flow decreased to 71.4% (not significant), 65% (P<0.01), 67.2% (P<0.001), and 72.3% (P<0.01) of the respective baseline values.


CONCLUSIONS
AT II-induced hypertension produced a relative increase in tumor blood flow. Oxygen-15 PET should be useful for predicting preferential drug delivery to hepatic cancers.
Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyou-ku, 602-8566 Kyoto, Japan. tkoh@ss.iij4u.or.jp
Toshimori
T
Koh
Hiroki
H
Taniguchi
Hisakazu
H
Yamagishi
D000328:Adult; D000368:Aged; D000804:Angiotensin II / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D008102:Liver Circulation / Q000187:drug effects*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010104:Oxygen Radioisotopes; D011169:Portal Vein / Q000000981:diagnostic imaging; D013154:Spleen / Q000098:blood supply / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed
D010104:Oxygen Radioisotopes; D000804:Angiotensin II