Axelsson Rimma, Bach-Gansmo Tore, Castell-Conesa Juan, McParland Brian J
Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Acta Radiol. 2010 Feb;51(1):40-6. doi: 10.3109/02841850903273974.
The alpha(v)beta(3) integrin is one of the angiogenesis-related membrane proteins highly expressed on the neovasculature of breast cancer and lung carcinomas. Labeling of the alpha(v)beta(3) integrin with (99m)Tc-NC100692 provides a potential tool for imaging angiogenesis and hence the presence of malignant lesions.
To determine the feasibility of detecting metastatic lesions in liver, lung, bone, and brain with scintigraphy using the alpha(v)beta(3)-avid imaging agent (99m)Tc-NC100692 in patients with breast or lung cancer, and to assess its safety profile.
Twenty-five patients--15 with lung cancer and 10 with breast cancer--were recruited at 10 centers. Metastases were newly diagnosed by computed tomography, magnetic resonance imaging, or bone scintigraphy, i.e., the reference standard. Patients underwent whole-body scans of approximately 10-15 min duration beginning at 45 min post-injection and a SPECT acquisition of approximately 30 min beginning at 75 min after injection of up to 1100 MBq (99m)Tc-NC100692. In case of liver metastases, dynamic acquisitions of 15 min were performed starting immediately post-injection. Safety measurements were performed up to 2.5 hours after injection and included hematology, serum biochemistry, coagulation, urine analysis, vital signs, oximetry, 12-lead ECG assessments, and a physical examination.
In patients with breast cancer, (99m)Tc-NC100692 scintigraphy detected 1 of 7 liver, 4 of 5 lung, 8 of 17 bone, and 1 of 1 brain metastases. The corresponding numbers for lung cancer patients were 0 of 2, 17 of 18, 2 of 2, and 7 of 9. There was overall stability through the follow-up period for all investigated safety parameters.
Scintigraphy with (99m)Tc-NC100692 is feasible for detection of lung and brain metastases from breast and lung cancer, while the detection of liver and bone lesions is poor. The use of (99m)Tc-NC100692 is safe and well tolerated.
α(v)β(3)整合素是一种与血管生成相关的膜蛋白，在乳腺癌和肺癌的新生血管上高度表达。用(99m)Tc-NC100692标记α(v)β(3)整合素为成像血管生成以及检测恶性病变的存在提供了一种潜在工具。
确定在乳腺癌或肺癌患者中使用α(v)β(3)亲和显像剂(99m)Tc-NC100692进行闪烁扫描检测肝、肺、骨和脑转移瘤的可行性，并评估其安全性。
在10个中心招募了25例患者，其中15例为肺癌患者，10例为乳腺癌患者。转移瘤通过计算机断层扫描、磁共振成像或骨闪烁扫描新确诊，即作为参考标准。患者在注射后45分钟开始进行约10 - 15分钟的全身扫描，并在注射高达1100 MBq(99m)Tc-NC100692后75分钟开始进行约30分钟的单光子发射计算机断层扫描(SPECT)采集。对于肝转移瘤，在注射后立即进行15分钟的动态采集。在注射后长达2.5小时进行安全性检测，包括血液学、血清生化、凝血、尿液分析、生命体征、血氧饱和度、12导联心电图评估和体格检查。
在乳腺癌患者中，(99m)Tc-NC100692闪烁扫描检测到7例肝转移瘤中的1例、5例肺转移瘤中的4例、17例骨转移瘤中的8例和1例脑转移瘤。肺癌患者的相应数字分别为2例中的0例、18例中的17例、2例中的2例和9例中的7例。在整个随访期间，所有研究的安全性参数总体稳定。
用(99m)Tc-NC100692进行闪烁扫描检测乳腺癌和肺癌的肺及脑转移瘤是可行的，而对肝和骨病变的检测效果较差。使用(99m)Tc-NC100692是安全的且耐受性良好。
