A pilot study imaging integrin αvβ3 with RGD PET/CT in suspected lung cancer patients

• Published in: European journal of nuclear medicine and molecular imaging 2015-12, Vol.42 (13), p.2029-2037
• Main Authors: Gao, Song, Wu, Honghu, Li, Wenwu, Zhao, Shuqiang, Teng, Xuepeng, Lu, Hong, Hu, Xudong, Wang, Suzhen, Yu, Jinming, Yuan, Shuanghu
• Format: Article
• Language: English
• Subjects: Aged; Cardiology; Coordination Complexes - adverse effects; Coordination Complexes - pharmacokinetics; Diagnosis, Differential; Female; Hamartoma - diagnostic imaging; Humans; Imaging; Integrin alphaVbeta3 - metabolism; Lung - diagnostic imaging; Lung Neoplasms - diagnostic imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging; Nuclear Medicine; Oncology; Original Article; Orthopedics; Peptides, Cyclic - adverse effects; Peptides, Cyclic - pharmacokinetics; Positron-Emission Tomography; Radiology; Radiopharmaceuticals - adverse effects; Radiopharmaceuticals - pharmacokinetics; Tomography, X-Ray Computed
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-015-3119-1

Purpose Angiogenesis is an essential step in tumour development and metastasis. Integrin αvβ3 plays a major role in angiogenesis, tumour growth and progression. A new tracer, 18 F-AL-NOTA-PRGD2, denoted as 18 F-alfatide, has been developed for positron emission tomography (PET) imaging of integrin αvβ3. This is a pilot study to test the safety and diagnostic value of 18 F- arginine-glycine-aspartic acid (RGD) PET/computed tomography (CT) in suspected lung cancer patients. Methods Twenty-six patients with suspected lung cancer on enhanced CT underwent 18 F-alfatide RGD PET/CT examination before surgery and puncture biopsy. Standard uptake values (SUVs) and the tumour-to-blood ratios were measured, and diagnoses were pathologically confirmed. Results RGD PET/CT with 18 F-alfatide was performed successfully in all patients and no clinically significant adverse events were observed. The 18 F-alfatide RGD PET/CT analysis correctly recognized 17 patients with lung cancer, 4 patients (hamartoma) as true negative, and 5 patients (4 chronic inflammation and 1 inflammatory pseudotumour) as false positive. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18 F-alfatide RGD PET/CT for the diagnosis of suspected lung cancer patients was 100, 44.44, 80.77, 77.27, and 100 %, respectively. The area under a receiver operating characteristic (ROC) curve was 0.75 ( P  = 0.038), and ROC analysis suggested an SUVmax cut-off value of 2.65 to differentiate between malignant lesions and benign lesions. The SUV for malignant lesions was 5.37 ± 2.17, significantly higher than that for hamartomas (1.60 ± 0.11; P