Novel methods and tracers for breast cancer imaging
Hannah M Linden1, Farrokh Dehdashti
1Department of Medicine, Division of Oncology, Seattle Cancer Care Alliance, Seattle, WA 98109-1023, USA. hmlinden@u.washington.edu
Abstract:
Although positron emission tomography (PET) using [(18)F]fluorodeoxyglucose (FDG) has an established role in breast cancer staging and monitoring response to therapy, more specifically novel targeted tracers are under investigation and hold promise toward identification of critical molecular targets of therapy. We review herein novel tracers in breast cancer including steroidal endocrine tracers, 16α-[(18)F]fluoro-17β-estradiol (FES) to measure tumor estrogen receptor density and function and 21-(18)F-fluoro-16α,17α-[(R)-(1'-α-furylmethylidene)dioxy]-19-norpregn-4-ene-3,20-dione (FFNP) to assay tumor progesterone receptor (PgR) expression, and to asses nuclear proliferation using 3'-deoxy-3'-fluorothymidine (FLT), membrane lipids using (11)C- or (18)F-labeled choline and amino acid transport using (11)C-methionine. These investigational tracers are moving closer to clinical use, and are likely to affect clinical care by aiding in characterization of breast cancer biology, which can have an important effect in the selection of targeted therapy and monitoring responsiveness to such therapy.
Insights
Novel positron emission tomography (PET) tracers offer enhanced breast cancer molecular characterization. These investigational agents promise to improve targeted therapy selection and monitor treatment response more effectively.
Area of Science:
- Oncology
- Radiochemistry
- Molecular Imaging
Background:
- Positron emission tomography (PET) with [(18)F]fluorodeoxyglucose (FDG) is standard for breast cancer staging and therapy response assessment.
- Emerging targeted PET tracers aim to identify critical molecular targets for personalized therapy.
Purpose of the Study:
- To review novel PET tracers for breast cancer molecular characterization.
- To highlight their potential impact on targeted therapy selection and response monitoring.
Main Methods:
- Review of investigational PET tracers including steroidal endocrine tracers (FES, FFNP), proliferation markers (FLT), and metabolic tracers (choline, methionine).
- Focus on tracers measuring estrogen receptor (ER), progesterone receptor (PgR), proliferation, and amino acid transport.
Main Results:
- Novel tracers like FES and FFNP can measure ER and PgR density/function.
- FLT assesses nuclear proliferation, while choline and methionine evaluate membrane lipids and amino acid transport.
- These tracers are advancing towards clinical application.
Conclusions:
- Investigational PET tracers provide deeper insights into breast cancer biology.
- They are expected to significantly influence the selection and monitoring of targeted therapies.
- Personalized breast cancer treatment will be enhanced by advanced molecular imaging.
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