Abstract
Purpose 99mTc-3PRGD2, a promising tracer targeting integrin receptor, may serve as a novel tumor-specific agent for single photon emission computed tomography (SPECT). A multi-center study was prospectively designed to evaluate the diagnostic accuracy of 99mTc-3PRGD2 imaging for bone metastasis in patients with lung cancer in comparison with the conventional 99mTc-MDP bone scan.MethodsThe patients underwent whole-body scan and chest tomography successively at both 1 h and 4 h after intravenous injection of 11.1 MBq/Kg 99mTc-3PRGD2. 99mTc-MDP whole-body bone scan was routinely performed within 1 week for comparison. Three experienced nuclear medicine physicians blindly read the 99mTc-3PRGD2 and 99mTc-MDP images. The final diagnosis was established based on the comprehensive assessment of all available data.ResultsA total of 44 patients (29 male, 59±10 years old) with suspected lung cancer were recruited from 4 centers. Eighty-nine bone lesions in 18 patients were diagnosed as metastases and 23 bone lesions in 9 patients were benign. In a lesion-based analysis, 99mTc-3PRGD2 imaging demonstrated a sensitivity, specificity, and accuracy of 92.1%, 91.3%, and 92.0%, respectively. The corresponding diagnostic values for 99mTc-MDP bone scan were 87.6%, 60.9%, and 82.1%, respectively in the same patients. 99mTc-MDP bone scan had better contrast in most lesions, whereas the 99mTc-3PRGD2 imaging seemed to be more effective to exclude pseudo-positive lesions and detect bone metastases without osteogenesis.Conclusion 99mTc-3PRGD2 is a novel tumor-specific agent based on SPECT technology with a promising value in diagnosis of bone metastasis in patients with lung cancer.Trial RegistrationClinicalTrials.gov NCT01737112
Highlights
Lung cancer is one of the most fatal diseases worldwide
The integrin avb3 receptor may be a promising target in the diagnosis, evaluation, and treatment of malignancies [9,10,11,12], serving as a tumor-specific agent for single photon emission computed tomography (SPECT)
We have preliminarily demonstrated that 99mTc-3PRGD2 imaging at 1 h after injection was sensitive for the detection of lung cancer [28]
Summary
Diagnosis and accurate evaluation of bone metastasis of lung cancer are essential for therapeutic planning and relapse monitoring [1,2,3]. An important member of the integrin family, is highly relevant to neoplastic angiogenesis, invasion, and metastasis. It is not expressed at all or expressed at a very low level on the quiescent endothelium and other normal tissues [4,5,6,7,8]. The integrin avb receptor may be a promising target in the diagnosis, evaluation, and treatment of malignancies [9,10,11,12], serving as a tumor-specific agent for single photon emission computed tomography (SPECT)
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