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Tc-99m MIBI SPECT is useful for noninvasively predicting the presence of MDR1 gene-encoded P-glycoprotein in patients with hepatocellular carcinoma.

Authors
Kim, YS; Cho, SW; Lee, KJ; Hahm, KB; Wang, HJ; Yim, H; Jin, YM; Park, CH
Citation
Clinical nuclear medicine, 24(11):874-879, 1999
Journal Title
Clinical nuclear medicine
ISSN
0363-97621536-0229
Abstract
PURPOSE: Resistance to chemotherapeutic drugs continues to be one of the major unsolved problems in the treatment of cancer. Multidrug resistance is defined as the ability of cells exposed to a single drug to develop resistance to a broad range of structurally and functionally unrelated drugs as a result of enhanced outward transport of drugs mediated by P-glycoprotein that is encoded by multidrug resistance genes. Recent evidence has shown that Tc-99m MIBI is a suitable transport substrate for P-glycoprotein. A potential advantage of Tc-99m MIBI SPECT is its superiority to diagnose noninvasively the presence of P-glycoprotein overexpression in vivo. In this study, the authors determined the association of enhanced MIBI efflux in Tc-99m MIBI SPECT with overexpression of P-glycoprotein in hepatocellular carcinoma.



MATERIALS AND METHODS: Thirty-five patients with hepatocellular carcinoma were enrolled in the study. Tc-99m MIBI SPECT was performed 10 minutes after intravenous injection of 20 mCi Tc-99m MIBI. All patients had liver biopsy or surgery within 1 week of MIBI imaging. Immunohistochemical study of the biopsy or resected hepatocellular carcinoma specimens was performed using the avidin-biotin-peroxidase technique with monoclonal antibody JSB-1 directed against P-glycoprotein.



RESULTS: On Tc-99m MIBI SPECT, 30 of 35 (85.7%) patients with hepatocellular carcinoma had no Tc-99m MIBI uptake in tumor lesions, whereas five patients with hepatocellular carcinoma had Tc-99m MIBI uptake in tumor lesions. P-glycoprotein expression was observed in tumor tissues of all the patients without Tc-99m MIBI uptake, whereas among the five patients with Tc-99m MIBI uptake, no P-glycoprotein expression was seen in tumor lesions (P < 0.015).



CONCLUSION: Tc-99m MIBI SPECT is useful for noninvasively predicting the presence of MDR1 gene-encoded P-glycoprotein in patients with hepatocellular carcinoma.
MeSH terms
Carcinoma, Hepatocellular/geneticsCarcinoma, Hepatocellular/radionuclide imaging*FemaleGene Expression Regulation, Neoplastic*Genes, MDRHumansImmunoenzyme TechniquesLiver/metabolismLiver Neoplasms/geneticsLiver Neoplasms/radionuclide imaging*MaleMiddle AgedP-Glycoprotein/biosynthesis*P-Glycoprotein/geneticsRadiopharmaceuticals/diagnostic useTechnetium Tc 99m Sestamibi/diagnostic use*Tomography, Emission-Computed, Single-Photon*
PMID
10551471
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Nuclear Medicine & Molecular Imaging
AJOU Authors
김, 영수조, 성원이, 광재함, 기백왕, 희정임, 현이진, 윤미박, 찬희
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