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Influence of glioma's multidrug resistance phenotype on (99m)Tc-tetrofosmin uptake
George A Alexiou1, Anna Goussia, Athanasios P Kyritsis
1Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece. alexiougrg@yahoo.gr
Purpose:
Multidrug resistance (MDR) remains a major obstacle to successful chemotherapeutic treatment of cancer. Several chemotherapeutic and radiopharmaceutical agents are substrates of the pumps encoded by the MDR genes, and therefore, their accumulation is prevented. We evaluated in vivo whether [(99m)Tc]tetrofosmin ((99m)Tc-TF) uptake is influenced by the MDR profile of gliomas.
Procedures:
Eighteen patients with histologically confirmed glioma were included in the study. Brain single-photon emission computed tomography by (99m)Tc-TF was performed within a week prior to surgical excision, and the expression of MRP5 was assessed by immunohistochemistry. Radiotracer accumulation was assessed by a semiquantitative method, calculating the lesion-to-normal uptake ratio.
Results:
Using Spearman's ρ analysis, we found no correlation between tracer uptake expressed as lesion-to-normal and MRP5 expression. There was a significant correlation between glioma aggressiveness as assessed by Ki-67/MIB-1 and MRP5 expression.
Conclusion:
The present data suggest that (99m)Tc-TF uptake is not influenced by glioma's MDR phenotype. Thus, (99m)Tc-TF constitutes a suitable radiotracer for imaging gliomas.
Insights
[(99m)Tc]tetrofosmin uptake is not affected by multidrug resistance (MDR) in gliomas. This finding suggests that (99m)Tc-tetrofosmin is a suitable radiotracer for imaging brain tumors.
Area of Science:
- Neuro-oncology
- Radiopharmacology
- Molecular imaging
Background:
- Multidrug resistance (MDR) hinders cancer chemotherapy by efflux pumps.
- Gliomas exhibit MDR, complicating treatment and imaging.
- Radiopharmaceutical uptake can be affected by MDR pumps.
Purpose of the Study:
- To investigate if multidrug resistance (MDR) influences [(99m)Tc]tetrofosmin ((99m)Tc-TF) uptake in gliomas.
- To assess the potential of (99m)Tc-TF as an MDR-independent imaging agent for gliomas.
Main Methods:
- Single-photon emission computed tomography (SPECT) with (99m)Tc-TF in 18 glioma patients.
- Immunohistochemical assessment of MDR-associated protein 5 (MRP5) expression.
- Semiquantitative analysis of radiotracer accumulation (lesion-to-normal uptake ratio).
Main Results:
- No significant correlation was found between (99m)Tc-TF uptake and MRP5 expression.
- A significant correlation existed between glioma aggressiveness (Ki-67/MIB-1) and MRP5 expression.
- Glioma MDR phenotype did not impact (99m)Tc-TF accumulation.
Conclusions:
- [(99m)Tc]tetrofosmin uptake is independent of the multidrug resistance profile in gliomas.
- (99m)Tc-TF demonstrates potential as a reliable radiotracer for glioma imaging.
- Further studies may explore (99m)Tc-TF in diverse glioma subtypes.
