A prospective head-to-head comparison of 68 Ga-NOTA-3P-TATE-RGD and 68 Ga-DOTATATE in patients with gastroenteropancreatic neuroendocrine tumours
A prospective head-to-head comparison of 68 Ga-NOTA-3P-TATE-RGD and 68 Ga-DOTATATE in patients with gastroenteropancreatic neuroendocrine tumours
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DOI：
10.1007/s00259-022-05852-3
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发表时间：
2022-06
影响因子：
9.1
通讯作者：
Yuanyuan Jiang;Qingxing Liu;Guochang Wang;Huimin Sui;Rongxi Wang;Jiarou Wang;Zhaohui Zhu
中科院分区：
文献类型：
--
作者：
Yuanyuan Jiang;Qingxing Liu;Guochang Wang;Huimin Sui;Rongxi Wang;Jiarou Wang;Zhaohui Zhu
目的本研究的目的是比较68镓-NOTA-3 P-TATE-RGD，生长抑素受体2-和整合素αVβ3-双靶向示踪剂，68镓-DOTATATE在一组患者胃肠胰腺（GEP）-神经内分泌肿瘤（NETs. Methods 35例患者组织学证实GEP-NETs（5级1，28级2，2级3肿瘤）的前瞻性入组知情同意。原发肿瘤主要来源于胰腺和直肠。所有患者均在一周内进行68 Ga-NOTA-3 P-TATE-RGD PET/CT和68 Ga-DOTATATE PET/CT扫描，并进行头对头比较。16例患者还接受了常规18F-FDG PET/CT检查。图像进行了半定量评估，使用最大标准化摄取值（SUVmax）的肿瘤和肿瘤背景ratio.ResultsAll患者至少有一个阳性病变的两个扫描。68 Ga-NOTA-3 P-TATE-RGD和68 Ga-DOTATATE PET/CT分别检测到1190和1106个病灶（P= 0.152）。68 Ga-NOTA-3 P-TATE-RGD PET/CT显示的肝脏病灶明显多于68 Ga-DOTATATE PET/CT（634 vs. 532，P= 0.021）。两种示踪剂在检测原发性肿瘤（20 vs. 20，P= 1.000）、淋巴结转移（101 vs. 102，P= 0.655）和骨转移（381 vs. 398，P= 0.244）方面的结果相当。12例患者中，68 Ga-NOTA-3 P-TATE-RGD组的SUVmax显著高于68 Ga-DOTATATE组（27.2 ± 13.6 vs.19.5 ± 10.0，P < 0.001），其中9例患者进行了18F-FDGPET/CT检查，均为FDG阳性。其余23例患者的68 Ga-DOTATATE摄取明显高于68 Ga-NOTA-3 P-TATE-RGD摄取（22.3 ± 16.4 vs. 11.9 ± 7.5，P < 0.001）;其中7例患者进行了18F-FDG PET/CT检查，6例患者FDG阴性。一般来说，68 Ga-DOTATATE组的肿瘤SUV max高于68 Ga-NOTA-3 P-TATE-RGD组（20.8 ± 16.0 vs.14.2 ± 8.9，P < 0.001），包括原发性肿瘤、肝脏病变、淋巴结病变和骨病变。然而，使用68 Ga-NOTA-3 P-TATE-RGD时肝脏病变的肿瘤与背景比明显高于使用68 Ga-DOTATATE时（8.4 ± 5.5 vs. 4.7 ± 3.7，P < 0.001）。结论68 Ga-NOTA-3 P-TATE-RGD在检测肝脏转移瘤方面优于68 Ga-DOTATATE，且肿瘤与背景比更高。此外，在FDG-avid NET中，68 Ga-NOTA-3 P-TATE-RGD倾向于表现出比68 Ga-DOTATATE更高的摄取。试验注册双重SSTR 2和整合素αvβ3靶向PET/CT成像（NCT 02817945，2018年11月5日注册）。注册网址https：clinicaltrials.gov/ct2/show/NCT02817945
PurposeThe aim of this study was to compare68Ga-NOTA-3P-TATE-RGD, a dual somatostatin receptor 2– and integrin αVβ3–targeting tracer, to68Ga-DOTATATE in a single group of patients with gastroenteropancreatic (GEP)-neuroendocrine tumours (NETs).MethodsThirty-five patients with histologically confirmed GEP-NETs (5 grade 1, 28 grade 2, and 2 grade 3 tumours) were prospectively enrolled with informed consent. The primary tumour mainly originated from the pancreas and rectum. All patients were scanned with both68Ga-NOTA-3P-TATE-RGD PET/CT and68Ga-DOTATATE PET/CT within a week and compared on a head-to-head basis. Sixteen patients also had conventional18F-FDG PET/CT. Images were evaluated semi-quantitatively using maximum standardized uptake values (SUVmax) of tumour and tumour-to-background ratio.ResultsAll patients had at least one positive lesion on each of the two scans. A total of 1190 and 1106 lesions were detected on68Ga-NOTA-3P-TATE-RGD images and68Ga-DOTATATE images, respectively (P= 0.152).68Ga-NOTA-3P-TATE-RGD PET/CT revealed significantly more lesions in the liver than68Ga-DOTATATE PET/CT (634 vs. 532,P= 0.021). Both tracers produced comparable results for detecting primary tumours (20 vs. 20,P= 1.000), lymph node metastases (101 vs. 102,P= 0.655), and bone metastases (381 vs. 398,P= 0.244). The tumourSUVmaxin 12 patients was significantly higher for68Ga-NOTA-3P-TATE-RGD than for68Ga-DOTATATE (27.2 ± 13.6 vs. 19.5 ± 10.0,P< 0.001); among them, 9 had18F-FDG PET/CT and all were found to be FDG-positive. The remaining 23 patients had significantly higher68Ga-DOTATATE uptake than68Ga-NOTA-3P-TATE-RGD uptake (22.3 ± 16.4 vs. 11.9 ± 7.5,P< 0.001); among them, 7 had18F-FDG PET/CT and 6 were FDG-negative. Generally,68Ga-DOTATATE demonstrated higher tumourSUVmaxthan68Ga-NOTA-3P-TATE-RGD (20.8 ± 16.0 vs. 14.2 ± 8.9,P< 0.001), including primary tumours, liver lesions, lymph node lesions, and bone lesions. However, the tumour-to-background ratio of liver lesions was significantly higher when using68Ga-NOTA-3P-TATE-RGD compared with that when using68Ga-DOTATATE (8.4 ± 5.5 vs. 4.7 ± 3.7,P< 0.001).Conclusion68Ga-NOTA-3P-TATE-RGD performed better than68Ga-DOTATATE in detection of liver metastases with a higher tumour-to-background ratio. Moreover,68Ga-NOTA-3P-TATE-RGD tended to demonstrate higher uptake over68Ga-DOTATATE in FDG-avid NETs.Trial registrationDual SSTR2 and Integrin αvβ3 Targeting PET/CT Imaging (NCT02817945, registered 5 November 2018).URL of registryhttps://clinicaltrials.gov/ct2/show/NCT02817945