Use of Molecular Imaging Markers of Glycolysis, Hypoxia and Proliferation (18F-FDG, 64Cu-ATSM and 18F-FLT) in a Dog with Fibrosarcoma: The Importance of Individualized Treatment Planning and Monitoring
Kamilla Westarp Zornhagen,
Malene M. Clausen,
Anders E. Hansen,
Ian Law,
Fintan J. McEvoy,
Svend A. Engelholm,
Andreas Kjær,
Annemarie T. Kristensen
Affiliations
Kamilla Westarp Zornhagen
Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark
Malene M. Clausen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark
Anders E. Hansen
Department of Micro- and Nanotechnology, Technical University of Denmark, Ørsteds Plads, Building 345E, DK-2800 Kgs. Lyngby, Denmark
Ian Law
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark
Fintan J. McEvoy
Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark
Svend A. Engelholm
Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2200 Copenhagen N, Denmark
Andreas Kjær
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark
Annemarie T. Kristensen
Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark
Glycolysis, hypoxia, and proliferation are important factors in the tumor microenvironment contributing to treatment-resistant aggressiveness. Imaging these factors using combined functional positron emission tomography and computed tomography can potentially guide diagnosis and management of cancer patients. A dog with fibrosarcoma was imaged using 18F-FDG, 64Cu-ATSM, and 18F-FLT before, during, and after 10 fractions of 4.5 Gy radiotherapy. Uptake of all tracers decreased during treatment. Fluctuations in 18F-FDG and 18F-FLT PET uptakes and a heterogeneous spatial distribution of the three tracers were seen. Tracer distributions partially overlapped. It appears that each tracer provides distinct information about tumor heterogeneity and treatment response.
