Diagnostic value of a novel RGD-peptide based tracer 18F-Alfatide II for breast cancer

2019 
Objective To investigate the biodistribution of 18F-Alfatide Ⅱ in patients with breast diseases and to compare its uptake with 18F-fluorodeoxyglucose (FDG) uptake. Methods A total of 44 female patients (age: (50.7±8.0) years) with clinically suspected breast cancer from December 2015 to May 2017 were prospectively enrolled and underwent 18F-Alfatide Ⅱ and 18F-FDG PET/CT prior to treatment. By drawing regions of interest in normal organs and breast lesions, differences between 18F-Alfatide Ⅱ uptake and 18F-FDG uptake were evaluated in all patients. Paired t test, two-sample t test and Wilcoxon rank sum test were used for data analysis. Results There were 53 breast lesions confirmed by histopathology in 44 patients. Among them, 42 lesions were malignant and the others were benign. The uptake of 18F-Alfatide Ⅱ was very low in the brain, vocal cords, lungs, blood pool and muscle. But the renal cortex and bladder had high 18F-Alfatide Ⅱ accumulation. Different levels of 18F-Alfatide Ⅱ uptake were found in other normal organs including normal breast tissue. There were differences (t values: 2.04-41.65, all P<0.05) between 18F-Alfatide Ⅱ and 18F-FDG maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean) in many normal organs except for the choroid plexus, salivary glands, liver, colon and normal breast tissue. The uptake of 18F-Alfatide Ⅱ was significantly lower than 18F-FDG in breast cancer lesions (SUVmax: 3.77±1.78 vs 7.37±4.48, SUVmean: 2.25±0.98 vs 4.54±2.82; t values: 4.89, 4.82, both P<0.05), but it was still higher in benign breast lesions (SUVmax: 2.37±1.62, SUVmean: 1.50±0.92; t values: 2.35, 2.29, both P<0.05). Also, target/non-target (T/NT) of 18F -Alfatide Ⅱ in breast cancer lesions was higher than that in benign breast lesions (5.32±3.08 vs 2.60±2.37; t=2.72, P<0.05). Conclusion The biodistribution of 18F-Alfatide Ⅱ in patients is favorable and 18F-Alfatide Ⅱ can be clinically used for breast cancer imaging. Key words: Breast neoplasms; Peptides, cyclic; Arg-Gly-Asp; Fluorine radioisotopes; Positron-emission tomography; Tomography, X-ray computed
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