Radionuclide Imaging of Apoptosis in Malignancies: Promise and Pitfalls of Tc-Hynic-rh-Annexin V Imaging

• Published in: Clinical Medicine Insights. Oncology 2008, Vol.2, p.319-325
• Main Authors: Kartachova, M S, Verheij, M, van Eck, B L, Hoefnagel, C A, Olmos, R A Valdes
• Format: Article
• Language: English
• ISSN: 1177-9314; 1177-9314; 1179-5549
• DOI: 10.4137/cmo.s349

Radionuclide detection of apoptosis with of (99m)Tc-Hynic-rh-Annexin V scintigraphy is an effective tool for in vivo visualisation and monitoring of apoptosis in various malignant tumour. Early therapy-induced increase of the tumour tracer uptake correlates with favourable outcome, whereas stable or decreased uptake correlates with stable disease or tumour progression. Therefore sequential (99m)Tc-Hynic-rh-Annexin V scintigraphy could be used to predict therapy outcome on a patient-to-patient basis within 48 hours after the start of treatment. However, moderate tumour-to-background ratio and therapy-induced changes in normal tissues could confound image analysis. To assure accurate interpretation of Annexin V scans, the awareness of the biophysiological and biochemical properties contributing to the tracer distribution is essential. In with manuscript we discuss the patterns of Annexin V tumour uptake and illustrate the most frequent pitfalls associated with Annexin V imaging in correlation with CT and MRI imaging.