title: 89Zr-bevacizumab PET imaging in primary breast cancer.
abstract: Vascular endothelial growth factor (VEGF)-A is overexpressed in most malignant and premalignant breast lesions. VEGF-A can be visualized noninvasively with PET imaging and using the tracer (89)Zr-labeled bevacizumab. In this clinical feasibility study, we assessed whether VEGF-A in primary breast cancer can be visualized by (89)Zr-bevacizumab PET.
  
  
  METHODS
  Before surgery, breast cancer patients underwent a PET/CT scan of the breasts and axillary regions 4 d after intravenous administration of 37 MBq of (89)Zr-bevacizumab per 5 mg. PET images were compared with standard imaging modalities. (89)Zr-bevacizumab uptake was quantified as the maximum standardized uptake value (SUV max). VEGF-A levels in tumor and normal breast tissues were assessed with enzyme-linked immunosorbent assay. Data are presented as mean ± SD.
  
  
  RESULTS
  Twenty-five of 26 breast tumors (mean size ± SD, 25.1 ± 19.8 mm; range, 4-80 mm) in 23 patients were visualized. SUV max was higher in tumors (1.85 ± 1.22; range, 0.52-5.64) than in normal breasts (0.59 ± 0.37; range, 0.27-1.69; P < 0.001). The only tumor not detected on PET was 10 mm in diameter. Lymph node metastases were present in 10 axillary regions; 4 could be detected with PET (SUV max, 2.66 ± 2.03; range, 1.32-5.68). VEGF-A levels in the 17 assessable tumors were higher than in normal breast tissue in all cases (VEGF-A/mg protein, 184 ± 169 pg vs. 10 ± 21 pg; P = 0.001), whereas (89)Zr-bevacizumab tumor uptake correlated with VEGF-A tumor levels (r = 0.49).
  
  
  CONCLUSIONS
  VEGF-A in primary breast cancer can be visualized by means of (89)Zr-bevacizumab PET.
authors: Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Sietske B M
authors: SB
authors: Gaykema
authors: Adrienne H
authors: AH
authors: Brouwers
authors: Marjolijn N
authors: MN
authors: Lub-de Hooge
authors: Rick G
authors: RG
authors: Pleijhuis
authors: Hetty
authors: H
authors: Timmer-Bosscha
authors: Linda
authors: L
authors: Pot
authors: Gooitzen M
authors: GM
authors: van Dam
authors: Sibylle B
authors: SB
authors: van der Meulen
authors: Johan R
authors: JR
authors: de Jong
authors: Joost
authors: J
authors: Bart
authors: Jakob
authors: J
authors: de Vries
authors: Liesbeth
authors: L
authors: Jansen
authors: Elisabeth G E
authors: EG
authors: de Vries
authors: Carolien P
authors: CP
authors: Schröder
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000493:pharmacokinetics*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011868:Radioisotopes; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D015040:Zirconium
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; D011868:Radioisotopes; D019275:Radiopharmaceuticals; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; C580636:89Zr-bevacizumab; D015040:Zirconium
keywords: 89Zr-bevacizumab PET; VEGF-A; breast cancer; early detection