Integrin Imaging with 99mTc-3PRGD2 SPECT/CT Shows High Specificity in the Diagnosis of Lymph Node Metastasis from Non-Small Cell Lung Cancer
Integrin Imaging with 99mTc-3PRGD2 SPECT/CT Shows High Specificity in the Diagnosis of Lymph Node Metastasis from Non-Small Cell Lung Cancer
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DOI：
10.1148/radiol.2016150813
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发表时间：
2016-12-01
期刊：
影响因子：
19.7
通讯作者：
Zhu, Zhaohui
中科院分区：
文献类型：
--
作者：
Jin, Xiaona;Liang, Naixin;Zhu, Zhaohui
目的：评价一种基于单光子发射计算机断层扫描(SPECT)/计算机断层扫描(CT)的整合素显像方法。方法：以~(99m)Tc-二聚环状精氨酸-甘氨酸-天冬氨酸(RGD)为示踪剂，以三个聚乙二醇间隔物(3PRGD2)为示踪剂，检测肺癌和淋巴结转移灶中整合素α(V)β(3)的表达。材料和方法：经伦理委员会批准和书面知情同意，对65例肺部可疑病变患者(男41例，女24例；平均年龄6 11岁[标准差])进行知情同意。患者在1周内同时行~(99)m-3PRGD2 SPECT/CT和18F-脱氧葡萄糖(FDG)正电子发射断层扫描(PET/CT)。病理诊断为非小细胞肺癌(NSCLC)的53例患者的65个肺部病变，12例患者的14个肺部病变为良性病变。按区域分析有转移区域248个，阴性区域56个。对20例切除的肺病变或淋巴结标本进行整合素α(V)、β(3)、CD34和Ki-67染色，并与图像表现进行对照。结果：在灵敏度相当的情况下，TC-99m-3PRGD2 SPECT/CT较F-18-FDG PET/CT更具特异性(特异度，94.6%比75.0%；P=0.008)。两种方法对肺肿瘤的逐灶诊断差异无统计学意义(z=0.82，P=.410)。(99)MTC-3PRGD2的积聚水平与肿瘤中整合素α(V)β(3)的表达(r=0.84，P=.001)和微血管密度(r=0.63，P=.011)呈正相关。结论：(99)MTC-3PRGD2 SPECT/CT对非小细胞肺癌淋巴结转移的诊断具有较高的特异性，有助于患者的手术决策。(C)RSNA，2016年
Purpose: To evaluate an integrin imaging approach based on single photon emission computed tomography (SPECT)/computed tomography (CT) by using technetium 99m (Tc-99m)-dimeric cyclic arginine-glycine-aspartic acid (RGD) peptides with three polyethylene glycol spacers (3PRGD2) as the tracer to target the integrin alpha(v)beta(3) expression in lung cancer and lymph node metastasis.Materials and Methods: With ethics committee approval and written informed consent, 65 patients (41 male, 24 female; mean age, 60 years 6 11 [standard deviation]) with suspicious lung lesions were recruited with informed consent. The patients underwent both Tc-99m-3PRGD2 SPECT/CT and fluorine 18 (F-18) fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT within 1 week. Finally, 65 lung lesions in 53 patients were pathologically diagnosed as non-small cell lung cancer (NSCLC) and 14 lung lesions in 12 patients were benign. Per-region analysis of lymph nodes included 248 regions with metastasis and 56 negative regions. Twenty specimens from the removed lung lesions or lymph nodes were stained with integrin alpha(v)beta(3), CD34, and Ki-67 to correlate with the image findings. Receiver operating characteristic curve, z statistics, McNemar test, and chi(2) analysis were used to compare the diagnostic performance of the two imaging methods.Results: Tc-99m-3PRGD2 SPECT/CT was found to be more specific than F-18-FDG PET/CT in the per-region diagnosis of lymph node metastasis (specificity, 94.6% vs 75.0%; P = .008) when the sensitivity of the two methods was comparable (88.3% vs 90.7%; P = .557). There was no significant difference between the two methods in the per-lesion diagnosis of lung tumor (z = 0.82, P = .410). The accumulation level of (99)mTc-3PRGD2 was found in positive correlation with the integrin alpha(v)beta(3) expression (r = 0.84, P = .001) and microvessel density (r = 0.63, P = .011) in the tumors.Conclusion: (99)mTc-3PRGD2 SPECT/CT shows high specificity in the diagnosis of lymph node metastasis from NSCLC, which may benefit surgical decision making for the patients. (C) RSNA, 2016