Sequential 99mTc-hydrazinonicotinamide-annexin V imaging for predicting response to chemotherapy.
This study was undertaken to evaluate changes in relative (99m)Tc-hydrazinonicotinamide (HYNIC)-annexin V tumor uptake over time in patients undergoing chemotherapeutic treatment at baseline and at 5-7 h and 40-44 h after treatment initiation. Imaging results are related to clinical outcomes, as assessed with response evaluation criteria in solid tumors (RECIST).


METHODS
We prospectively included 20 patients (11 men and 9 women; mean age, 59.8 y; range, 22-75 y) scheduled for chemotherapy (n = 19) or bisphosphonate treatment (n = 1). Curable disease was present in 5 patients. The other patients had metastatic disease and were treated in a palliative setting. Three of the 20 enrolled patients were excluded from analysis: 1 patient ultimately refused the proposed chemotherapy treatment; because of difficulties with the labeling procedure, 1 patient did not receive a pretreatment scan; and 1 patient presented with an allergic reaction (rash and nausea) to the (99m)Tc-HYNIC-annexin V formulation. The remaining 17 patients underwent 3 scintigraphic scans with (99m)Tc-HYNIC-annexin V: before treatment and 5-7 h and 40-44 h after treatment initiation. The tumor response was evaluated with RECIST and related to observed changes in the ratios of tumor activity to background activity for the largest known lesion; values exceeding 25% the baseline value on either the 5- to 7-h scan or the 40- to 44-h scan were considered significant.


RESULTS
With the proposed sequential imaging protocol and a 25% change threshold, responders to treatment could be separated from nonresponders with a 94% accuracy (16/17 patients).


CONCLUSIONS
Sequential (99m)Tc-HYNIC-annexin V imaging may allow for assessment of the response to chemotherapy within 3 d after treatment initiation.
Rottey
Sylvie
S
Division of Medical Oncology, Department of Internal Medicine, University Hospital Ghent, Ghent, Belgium.
Slegers
Guido
G
Van Belle
Simon
S
Goethals
Ingeborg
I
Van de Wiele
Christophe
C
D000328:Adult; D000368:Aged; D017304:Annexin A5; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D015609:Organotechnetium Compounds; D013667:Technetium; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging
D017304:Annexin A5; D000970:Antineoplastic Agents; D004164:Diphosphonates; D015609:Organotechnetium Compounds; C515698:technetium Tc 99m hydrazinonicotinamide-annexin V; D013667:Technetium