Comparison of [99mTc]3PRGD2 Imaging and [18F]FDG PET/CT in Breast Cancer and Expression of Integrin αvβ3 in Breast Cancer Vascular Endothelial Cells

• Published in: Molecular imaging and biology 2018-10, Vol.20 (5), p.846-856
• Main Authors: Chen, Zhenying, Fu, Fangmeng, Li, Fang, Zhu, Zhaohui, Yang, Yinghong, Chen, Xiangjin, Jia, Bing, Zheng, Shan, Huang, Chao, Miao, Weibing
• Format: Article
• Language: English
• Subjects: Arginine; Aspartic acid; Biopsy; Breast cancer; Cancer; Computed tomography; Diagnosis; Endothelial cells; ErbB-2 protein; Fluorine isotopes; Glucose; Glycine; Imaging; Immunohistochemistry; Lesions; Lymph; Lymph nodes; Lymphatic system; Mammography; Medicine; Medicine & Public Health; Metastases; Metastasis; Patients; Polyethylene glycol; Polyethylene terephthalate; Quantitative analysis; Radiology; Research Article; Sensitivity
• ISSN: 1536-1632; 1860-2002
• DOI: 10.1007/s11307-018-1178-y

Purpose This study aimed to investigate the value of 99m technetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid ([ 99m Tc]3PRGD 2 ) imaging in diagnosis and staging of breast cancer compared with 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) imaging, and to explore the expression of integrin α v β 3 in tumor vascular endothelial cells. Procedures Forty-two women with suspected breast cancer underwent both [ 99m Tc]3PRGD 2 imaging and [ 18 F]FDG imaging. Visual analysis was used to assess primary breast lesion, axillary lymph node, and distant metastasis. The tumor-blood (T/B) ratios from [ 99m Tc]3PRGD 2 imaging and the maximum standardized uptake value (SUVmax) from [ 18 F]FDG imaging were analyzed for breast lesions. Integrin α v β 3 was analyzed through immunohistochemistry. Results Forty-five breast lesions were found (malignant, n  = 38; benign, n  = 7). The sensitivity, specificity, and accuracy of [ 99m Tc]3PRGD 2 and [ 18 F]FDG imaging in visual analysis for the breast lesion were 97.4, 87.5, and 95.6 % and 97.4, 71.4, and 93.3 %, respectively ( P  > 0.05). For semi-quantitative analysis, no significant difference of the area under the curves (AUC) was found in the imaging using the two radiopharmaceuticals (0.880 and 0.955; Z  = 0.88, P  > 0.05). The sensitivity, specificity, and accuracy for axillary lymph node metastasis with [ 99m Tc]3PRGD 2 and [ 18 F]FDG were 78.05, 99.36, and 94.92 % and 85.37, 98.72, and 95.64 %, respectively ( P  > 0.05). Nine patients with distant metastases were all detected with the two radiopharmaceuticals. The expression of integrin α v β 3 was correlated with [ 99m Tc]3PRGD 2 uptake ( r  = 0.582, P  = 0.001), which were significantly higher in the HER2-positive and stage III–IV patients ( P