99mTc-3PRGD2 for integrin receptor imaging of lung cancer: a multicenter study
Zhaohui Zhu, Weibing Miao, Qianwei Li, Haojie Dai, Qingjie Ma, Feng Wang, Aiming Yang, Bing Jia, Xiaona Jing, Sha Liu, Jiyun Shi, Zhaofei Liu, Zhoushe Zhao, Fan Wang, Fang Li, Zhaohui Zhu, Weibing Miao, Qianwei Li, Haojie Dai, Qingjie Ma, Feng Wang, Aiming Yang, Bing Jia, Xiaona Jing, Sha Liu, Jiyun Shi, Zhaofei Liu, Zhoushe Zhao, Fan Wang, Fang Li
Abstract
(99m)Tc-3PRGD2 is a new SPECT tracer targeting integrin α(V)β(3) receptor for detecting tumors, imaging angiogenesis, and evaluating tumor response to therapy. A multicenter study was designed to investigate the efficacy of (99m)Tc-3PRGD2 for the evaluation of patients with lung cancer.
Methods: Seventy patients (51 men, 19 women; mean age ± SD, 63 ± 9 y) with a suspected lung lesion and for whom definite pathologic diagnosis was finally obtained (malignant, n = 58; benign, n = 12) were recruited from 6 centers. Whole-body planar scanning and chest SPECT were performed at 1 and 4 h, respectively, after intravenous injection of 11.1 MBq/kg (0.3 mCi/kg) of (99m)Tc-3PRGD2. The images were read in consensus by 6 experienced nuclear medicine physicians masked to the source, history, and pathologic diagnosis. The tumor-to-background (T/B) ratios were calculated for semiquantitative analysis. A Student t test was used for statistical analysis, and a P value less than 0.05 was considered significant.
Results: With low (99m)Tc-3PRGD2 background in the lungs and mediastinum, most lung malignancies were prominent on the 1-h images (T/B ratio, 1.65 ± 0.47 for the planar imaging and 2.78 ± 1.52 for SPECT). The T/B ratios were significantly lower in the benign lesions (P < 0.05). The sensitivity was 88% for semiquantitative analysis and could reach 93%-97% in visual analysis when considering the volume effect, necrosis, and metastasis. However, the specificity was only 58%-67%. Most lymph node and bone metastases could also be detected.
Conclusion: (99m)Tc-3PRGD2 imaging at 1 h is sensitive for the detection of lung cancer, meriting further investigation of (99m)Tc-3PRGD2 as a novel clinical tracer for integrin receptor imaging.
Source: PubMed