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Evaluation of Lung Cancer and Neuroendocrine Neoplasm in a Single Scan by Targeting Both Somatostatin Receptor and Integrin αvβ3

Zheng, Yumin MD*†; Wang, Hanping MD; Tan, Huangying MD§; Cui, Xiaoxia MD; Yao, Shaobo PhD*∥; Zang, Jie MD*; Zhang, Li MD; Zhu, Zhaohui MD

doi: 10.1097/RLU.0000000000002680
Original Articles

Purpose This pilot study aimed to prove the complementary value of a novel 68Gallium-labeled heterodimeric peptide, 68Ga-NOTA-3P-TATE-RGD, in detection and evaluation of tumors with somatostatin receptor subtype 2 or integrin αvβ3 overexpression, including non-small cell lung cancer (NSCLC), small-cell lung cancer (SCLC), neuroendocrine tumor (NET), and neuroendocrine carcinoma (NEC).

Methods With institute review board approval and written informed consent, 32 patients with pathologically diagnosed lung cancer (18 NSCLC, 14 SCLC) and 12 patients with neuroendocrine neoplasm (8 NET, 4 NEC) patients were recruited to undergo 68Ga-NOTA-3P-TATE-RGD PET/CT. For comparison, the NSCLC patients also underwent 68Ga-NOTA-TATE PET/CT, the SCLC patients underwent 68Ga-NOTA-RGD PET/CT, and the neuroendocrine neoplasm patients underwent 18F-FDG PET/CT within 3 days. The maximum standardized uptake value (SUV) of the primary tumor (T) and mean SUV of the blood pool (B) were measured, and the T/B ratios were calculated for comparison.

Results In the primary tumors of NSCLC, the T/B ratios of 68Ga-NOTA-3P-TATE-RGD were significantly higher than those of 68Ga-NOTA-TATE (4.54 ± 3.00 versus 4.10 ± 2.83, P = 0.0058). In SCLC, the T/B ratios of 68Ga-NOTA-3P-TATE-RGD were significantly higher than those of 68Ga-NOTA-RGD (6.06 ± 6.09 versus 2.65 ± 1.19, P = 0.0344). In NET, the T/B ratios of 68Ga-NOTA-3P-TATE-RGD were 36.13 ± 33.84, significantly higher than those of 18F-FDG (2.91 ± 1.71, P = 0.0234). In NEC, there were no significant difference between the T/B ratios of 68Ga-NOTA-3P-TATE-RGD (4.80 ± 0.85) and those of 18F-FDG (3.56 ± 0.74, P = 0.1833).

Conclusions This proof-of-concept study preliminarily demonstrates the efficacy of the dual targeting 68Ga-NOTA-3P-TATE-RGD PET/CT in the evaluation of lung cancer and neuroendocrine neoplasm in a single scan.

From the *Department of Nuclear Medicine and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC

Department of Nuclear Medicine, China-Japan Friendship Hospital

Respiratory Department, PUMC Hospital, CAMS and PUMC

§Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing

PET-CT Center, General Hospital of Tianjin Medical University, Tianjin

Key Laboratory of Endocrinology of National Health and Family Planning Commission, PUMC Hospital, CAMS and PUMC, Beijing, People’s Republic of China.

Received for publication November 12, 2018; revision accepted May 9, 2019.

Conflicts of interest and sources of funding: This study was partly supported by the Key Special Project on Inter-Governmental Scientific and Technological Innovation Cooperation in National Key Research and Development Plan (2016YFE0115400), the Chinese Academy of Medical Science Major Collaborative Innovation Project (2016-I2M-1-011), National Nature Science Foundation (81741142, 81871392), and Beijing Municipal Natural Science Foundation (7161012). None declared to all authors.

Correspondence to: Zhaohui Zhu, MD, Department of Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and PUMC, Beijing 100730, People’s Republic of China. E-mail:

Online date: July 5, 2019

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