title: Molecular imaging using PET and SPECT for identification of breast cancer subtypes.
abstract: Breast cancer is a major disease with high morbidity and mortality in women. As a highly heterogeneous tumor, it contains different molecular subtypes: luminal A, luminal B, human epidermal growth factor 2-positive, and triple-negative subtypes. As each subtype has unique features, it may not be universal to the optimal treatment and expected response for individual patients. Therefore, it is critical to identify different breast cancer subtypes. Targeting subcellular levels, molecular imaging, especially PET and single photon emission computed tomography, has become a promising means to identify breast cancer subtypes and monitor treatment. Different biological processes between various subtypes, including changes correlated with receptor expression, cell proliferation, or glucose metabolism, have the potential for imaging with PET and single photon emission computed tomography radiopharmaceuticals. Receptor imaging, with radiopharmaceuticals targeting estrogen receptor, progesterone receptor, or human epidermal growth factor 2, is available to distinguish receptor-positive tumors from receptor-negative ones. Cell proliferation imaging with fluorine-18 fluorothymidine PET aids identification of luminal A and B subtypes on the basis of the correlation with the immunohistochemical biomarker Ki-67. Glucose metabolism imaging with fluorine-18 fluorodeoxyglucose PET may have potential to discriminate triple-negative subtypes from others. With increasing numbers of novel radiopharmaceuticals, noninvasive molecular imaging will be applied widely for the identification of different subtypes and provide more in-vivo information on individualized management of breast cancer patients.
authors.affiliation: aDepartment of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine bZhejiang University Medical PET Center cInstitute of Nuclear Medicine and Molecular Imaging, Zhejiang University dKey Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Yao
authors.initials: Y
authors.lastname: Chen
authors.forename: Shuang
authors.initials: S
authors.lastname: Wu
authors.forename: Fahuan
authors.initials: F
authors.lastname: Song
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Mei
authors.initials: M
authors.lastname: Tian
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging* / Q000378:metabolism; D049109:Cell Proliferation; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008325:Mammary Neoplasms, Experimental / Q000145:classification / Q000000981:diagnostic imaging / Q000378:metabolism; D057054:Molecular Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D005947:Glucose; D019275:Radiopharmaceuticals; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human