Abstract
Angiogenesis plays a key role in tumor development and αvβ3 integrin are overexpressed on the endothelial cell surface of newly forming vessels. 18F-Alfatide has favorable properties for αvβ3 integrin targeting and showed potential for imaging angiogenesis with Positron Emission Tomography (PET)/computed tomography (CT). In this study, 13 patients with non-small cell lung cancer (NSCLC) who underwent 18F-Alfatide PET/CT before surgery were enrolled. The uptake of all dissected lymph nodes (LNs) of 18F-Alfatide were assessed visually and analyzed with a maximum and mean standard uptake value (SUVmax, SUVmean) and SUV ratios. LN metastases were pathologically confirmed and 20 of 196 LNs were malignant. All malignant LNs were successfully visualized on 18F-Alfatide PET/CT in patients and the sensitivity, specificity and accuracy was 100.0%, 94.9% and 95.4%, respectively. SUVmax, SUVmean and SUV ratios in malignant LNs were significantly higher than in benign LNs for NSCLC patients (P < 0.001). The same result was observed in patients with adenocarcinoma and squamous cell carcinoma (P < 0.001). The 18F-Alfatide parameter shows high sensitivity (83.9–100%), specificity (78.6–96.7%) and accuracy (81.7–96.9%) according to thresholds calculated from receiver operating characteristic curve. Our results suggest that 18F-Alfatide PET/CT is valuable in the diagnosis of metastatic LNs for NSCLC patients.
Highlights
18F-AlF-NOTA-PRGD2 (18F-Alfatide), a novel tracer targeting integrin αvβ[3], has been studied for angiogenesis imaging by positron emission tomography (PET)[2, 3]
Twenty of the resected 196 lymph nodes (10.2%) were malignant in patients with NSCLC, six of 104 lymph nodes were malignant in patients with adenocarcinoma (AC) and 5 of the resected 65 lymph nodes were malignant in patients with squamous cell carcinoma (SCC)
This is a pilot clinical research to evaluate the prognostic value of the 18F-Alfatide Positron Emission Tomography (PET)/CT in detecting mediastinal lymph node metastases (LNMs) in patients with NSCLC
Summary
18F-AlF-NOTA-PRGD2 (18F-Alfatide), a novel tracer targeting integrin αvβ[3], has been studied for angiogenesis imaging by positron emission tomography (PET)[2, 3]. Tumor angiogenesis can be evaluated by imaging αvβ[3] expression, making the integrin receptor αvβ[3] a valuable target for diagnosing malignant tumors and metastases[3]. 18F-Alfatide, a new one-step labeled integrin αvβ3-targeting PET probe, is simple and time-saving when synthesized compared with various 18F-labelled RGD peptide tracers[3], including 18F-galacto-RGD15–18, 18F-AH11158519, 20, 18F-RGD-K521, 18FFPRGD2 and 18F-FPPRGD222. 18F-Alfatide was used as a novel tracer for integrin αvβ[3] PET/CT examination in this present research. The objective was to detect lymph node metastases (LNMs) in patients with NSCLC, and to conduct a pilot research of 18F-Alfatide PET/CT diagnostic ability in the imaging of mediastinal LNMs in patients with NSCLC
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