European Journal of Nuclear Medicine

, Volume 15, Issue 2, pp 61–66 | Cite as

[18F]Fluorodeoxyglucose scintigraphy in diagnosis and follow up of treatment in advanced breast cancer

  • Heikki Minn
  • Irma Soini


Seventeen patients with advanced breast cancer were imaged with a specially collimated gamma camera to study tumor uptake of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) before and during therapy. Fourteen patients (82%) showed increased FDG accumulation in metastatic tumors, 6/8 (75%) of axillary, supra or infraclavicular metastatic lymph nodes were detectable. In one of these cases, FDG imaging was the first method to identify axillary metastasis causing nerve compression. Also, pulmonary and liver metastases could be imaged with FDG; both in two patients. The intra individual variability in uptake was considerable in bone metastases, and some lesions remained FDG negative:99mTc-DPD was superior in detecting bone disease. Bone metastases of the osteolytic or mixed type were better visualized than sclerotic ones. Ten patients were reimaged later to assess the effect of therapy on FDG uptake. Increased uptake was associated with clinical progression, while unchanged or diminished uptake did not predict the course of disease as reliably. This study indicates that FDG can be used to image breast cancer metastases. FDG may be valuable in monitoring treatment response, but positron emission tomography (PET) would probably be more appropriate than planar imaging for this purpose.

Key words

Breast neoplasms Radionuclide imaging Fluorodeoxyglucose Cancer chemotherapy Therapy response 


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  1. Abe Y, Matsuzawa T, Fujiwara T, Fukuda H, Itoh M, Yamada K, Yamaguchi K, Sato T, Ido T (1986) Assessment of radiotherapeutic effects on experimental tumors using18F-2-fluoro-2-deoxy-D-glucose. Eur J Nucl Med 12:325–328Google Scholar
  2. Ahonen A, Paul R, Aho A, Dean P, Roeda D, Solin O, Virtama P, Ekfors T, Nordman E, Haaparanta M, Wegelius U (1986) Differential diagnosis of bone tumors using fluorodeoxyglucose and three phase99mTc-DPD scanning. In: Schmidt HAE, Ell PJ, Britton KE (eds) Nuclearmedizin. Proc. ENMC. Schattauer, Stuttgart New York, pp 441–443Google Scholar
  3. d'Argy R, Paul R, Frankenberg L, Stålnacke CG, Lundqvist H, Kangas L, Halldin C, Någren K, Roeda D, Haaparanta M, Solin O, Långström B (1988) Comparative double-tracer wholebody autoradiography: uptake of11C-,18F-, and3H-labeled compounds in rat tumors. Int J Nucl Med Biol 15:577–585Google Scholar
  4. Beaney RP, Lammertsma AA, Jones T, McKenzie CG, Halnan KE (1984) Positron emission tomography for in-vivo measurement of regional blood flow, oxygen utilisation, and blood volume in patients with breast carcinoma. Lancet 1:131–134Google Scholar
  5. Bolster JM, Vaalburg W, Paans AMJ, van Dijk TH, Elsinga PH, Zijlstra JB, Piers DA, Mulder NH, Woldring MG, Wynberg H (1986) Carbon-11 labelled tyrosine to study tumor metabolism by positron emission tomography (PET). Eur J Nucl Med 12:321–324Google Scholar
  6. Campbell FC, Blamey RW, Elston CW, Morris AH, Nicholson RI, Griffiths K, Haybittle JL (1981) Quantitative oestradiol receptor values in primary breast cancer and response of metastases to endocrine therapy. Lancet 2:1317–1319Google Scholar
  7. Di Chiro G (1986) Positron emission tomography using [18F]fluorodeoxyglucose in brain tumors: a powerful diagnostic and prognostic tool. Invest Radiol 22:360–371Google Scholar
  8. Di Chiro G, Hatazawa J, Katz DA, Rizzoli HV, De Michele DJ (1987) Glucose utilization by intracranial meningiomas as an index of tumor aggressivity and probability of recurrence: a PET study. Radiology 164:521–526Google Scholar
  9. Fisher ER (1984) The impact of pathology on the biologic, diagnostic, prognostic, and therapeutic considerations in breast cancer. Surg Clin North Am 64:1073–1093Google Scholar
  10. Fukuda H, Ito M, Matsuzawa T, Abe Y, Yoshioka S, Kubota K, Kiyosawa M, Hatazawa J, Ito K, Fujiwara T, Yamada K, Ido T (1983) Clinical evaluation of cancer diagnosis with18F-2-deoxy-2-fluoro (18F)-D-glucose. CYRIC annual report 1983:244–249Google Scholar
  11. Gallagher BM, Fowler JS, Gutterson NI, MacGregor RR, Wan CN, Wolf AP (1978) Metabolic trapping as a principle of radiopharmaceutical design: some factors responsible for the biodistribution of (18F)2-deoxyglucose. J Nucl Med 19:1154–1161Google Scholar
  12. Hayward JL, Carbone PP, Heuson JC, Kumaska S, Segaloff A, Reubens RD (1977) Assessment of response to therapy in advanced breast cancer. Cancer 39:1289–1293Google Scholar
  13. Haaparanta M, Bergman J, Solin O, Roeda D (1984) A remotely controlled system for the routine synthesis of18F-2-fluoro-2-deoxy-D-glucose. Nuklearmedizin 21 [Suppl]:823–826Google Scholar
  14. Harris JR, Schnitt SJ, Connolly JL, Silen W (1987) Conservative surgery and radiation therapy for early breast cancer. Arch Surg 122:754–755 (editorial)Google Scholar
  15. Iosilevsky G, Front D, Bettman L, Hardoff R, Ben-Arieh Y (1985) Uptake of gallium-67 citrate and [2-3H] deoxyglucose in the tumor model, following chemotherapy and radiotherapy. J Nucl Med 26:278–282Google Scholar
  16. Joensuu H, Ahonen A (1987) Imaging of metastases of thyroid carcinoma with fluorine-18 fluorodeoxyglucose. J Nucl Med 28:910–914Google Scholar
  17. Minn H, Joensuu H, Ahonen A, Klemi P (1988a) Fluorodeoxyglucose imaging: a method to assess the proliferative activity of human cancer in vivo. Cancer 61:1776–1781Google Scholar
  18. Minn H, Paul R, Ahonen A (1988b) Evaluation of treatment response to radiotherapy in head and neck cancer with (18F)fluorodeoxyglucose. J Nucl Med 21:1521–1525Google Scholar
  19. Mintun MA, Welch MJ, Mathias CJ (1987) Application of 16α-[F-18]-fluoro-17β-estradiol (I) for the assessment of estrogen receptors in human breast carcinoma. J Nucl Med 28 [Suppl.]:561 A:19 (abstr)Google Scholar
  20. Nolop KB, Rhodes CG, Brudin LH, Beaney RP, Krausz T, Jones T, Hughes JMB (1987) Glucose utilization in vivo by human pulmonary neoplasms. Cancer 60:2682–2689Google Scholar
  21. Patronas NJ, DiChiro G, Brooks RA, DeLaPaz RL Kornblith PL, Smith HH, Rizzoli HV, Kessler RM, Manning RG, Channing M, Wolf AP, O'Connor CM (1982) Work in progress:18F fluorodeoxyglucose and emission tomography in the evaluation of radiation necrosis of the brain. Radiology 144:885–889Google Scholar
  22. Paul R, Roeda D, Johansson R, Ahonen A, Haaparanta M, Solin O, Sipilä H (1986) Scintigraphy with [18F]2-fluoro-2-deoxy-D-glucose of cancer patients. Int J Nucl Med Biol 13:7–12Google Scholar
  23. Phelps ME, Huang SC, Hoffman EJ, Selin C, Sokoloff L, Kuhl DE (1979) Tomographic measurement of local cerebral glucose metabolic rate in humans with (F-18) 2-fluoro-2-deoxy-D-glucose: validation of a method. Ann Neurol 6:371–388Google Scholar
  24. Schelstraete K, Simons M, Deman J, Vermeulen FL, Slegers G, Vandecasteele C, Goethals P, De Schryver A (1982) Uptake of13N-ammonia by human tumours as studied by positron emission tomography. Br J Radiol 55:797–804Google Scholar
  25. Sokoloff L, Reivich M, Kennedy C, DesRosiers MH, Patlak CS, Pettigrew KD, Sakurada O, Shinohara M (1977) The (14C) deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anesthetized albino rat. J Neurochem 28:897–916Google Scholar
  26. Som P, Atkins HL, Bandoypadhyay D, Fowler JS, McGregor RR, Matsui L, Oster ZH, Sacker DF, Shiue CY, Turner H, Wan C-N, Wolf AP, Zabinski SV (1980) A fluorinated glucose analog 2-fluoro-2-deoxy-D-glucose (F-18): Nontoxic tracer for rapid tumor detection. J Nucl Med 21:670–675Google Scholar
  27. Takahashi H, Yamaguchi K, Wakui A, Maeda S, Kong Yang P, Ito M, Matsuzawa T, Fukuda H, Ido T (1986a) New approach to clinical evaluation of cancer chemotherapy using positron emission tomography with18FDG(2-deoxy-2-[18F] fluoro-D-glucose. Sci Rep Res Inst Tokohu Univ 33:38–43Google Scholar
  28. Takahashi H, Maeda S, Yang PK, Wakui A, Ishiwata K, Iwata R, Takahashi T, Ido T (1986b) Changes in growth and18FDG(2-deoxy-2-[18F]fluoro-D-glucose) uptake of rat hepatomas by anticancer drugs. CYRIC Annual Report 1986:195–200Google Scholar
  29. UICC (International Union Against Cancer) (1978) TNM classification of malignant tumours. Harmer MH (ed), Third edition, Geneva, pp 47–54Google Scholar
  30. Walker RA, Sanderson PR, Day SJ (1986) The utilization of [3H] sugars by non-malignant and malignant human breast. J Pathol 149:173–181Google Scholar
  31. Weber MJ (1984) Metabolic and transport alterations in cells transformed by Rous sarcoma virus. In: Knapp WH, Vyska K (eds) Tumor cell physiology and positron emission tomography. Springer, Berlin Heidelberg New York pp 1–9Google Scholar
  32. Weinhouse S (1972) Glycolysis, respiration, and anomalous gene expression in experimental hepatoma: G.H.A. Clowes memorial lecture. Cancer Res 32:2007–2016Google Scholar
  33. Weisenthal LM, Lippman ME (1985) Clonogenic and nonclonogenic in vitro chemosensitivity assays. Cancer Treat Rep 69:615–632Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • Heikki Minn
    • 1
  • Irma Soini
    • 2
  1. 1.Department of RadiotherapyUniversity Central Hospital of Turku Turku Medical Cyclotron ProjectTurkuFinland
  2. 2.Department of Radiology and Nuclear MedicineUniversity Central Hospital of Turku Turku Medical Cyclotron ProjectTurkuFinland

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