Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655.
Nucl Med Biol. 2014 Jan;41(1):127-31. doi: 10.1016/j.nucmedbio.2013.10.001. Epub 2013 Oct 9.
The differences between two agents often need to be accurately defined in vivo. Usually they are injected respectively into two groups of subjects. However, if the two agents do not interact with each other in vivo, a coinjection would serve the same purpose. We believe some individual differences in biodistribution may be circumvented through this approach by calculating organ level ratios.
A model system of MORF/cMORF pretargeting (MORF/cMORF is a complementary pair of DNA analogues) was employed in connection with an on-going tumor therapeutic project. Human LS174T cells were implanted into the flank of severely immuno-compromised NOD-scid IL2rg(null) mice. The tumor was confirmed to express TAG-72 antigens. At 16 days post tumor inoculation, mice received IV 60 μg of MORF-conjugated CC49 (an antiTAG-72 antibody), followed 2 days later by a low-mass-dose IV coinjection containing 2.5 μg of (90)Y-cMORF and 2.5 μg of (99m)Tc-cMORF. At 3 h post radioactivity injection, the distribution of (99m)Tc was imaged on a SPECT/CT camera and then organs were excised and counted for (90)Y and (99m)Tc. Because the two labeled cMORFs do not react or interact with each other in vivo, the two groups of (90)Y and (99m)Tc data enabled a conventional group comparison. In a new effort, (90)Y/(99m)Tc ratios were calculated. Student's t-test and retrospective power analysis were performed for both approaches. In the new approach, the ratios were set at 1 as the null hypothesis.
The Student's t-test in the conventional group approach indicated that the two labeled cMORFs distributed similarly, but significant differences were observed in salivary gland and large intestines. The coinjection-ratio approach certainly did not subvert the results of the conventional approach but revealed subtler differences. The P values were reduced, the powers were increased in most organs, and more significant differences were observed. The increased sensitivity was due to the reduced CV%s (SD/average*100%) of the (90)Y/(99m)Tc ratios. Therefore, some individual differences were circumvented and notably the ratio approach differentiated individual differences into ratio-correctable and ratio-uncorrectable.
Although the conventional approach is reliable, the coinjection-ratio approach using organ level ratios is more sensitive and therefore is recommended whenever possible. In addition, it differentiates individual differences into "coinjection correctable" and "coinjection uncorrectable".
通常情况下,需要在体内准确地定义两种药物之间的差异。通常,它们分别注射到两组受试者中。然而,如果两种药物在体内不相互作用,那么共注射就可以达到同样的目的。我们相信,通过这种方法计算器官水平的比值,可以避免一些个体差异导致的生物分布差异。
我们采用了 MORF/cMORF 预靶向(MORF/cMORF 是一对互补的 DNA 类似物)模型系统,与正在进行的肿瘤治疗项目相关联。将人 LS174T 细胞植入严重免疫缺陷的 NOD-scid IL2rg(null) 小鼠的侧腹。肿瘤被证实表达 TAG-72 抗原。在肿瘤接种后 16 天,小鼠接受 IV 注射 60μg 的 MORF 缀合的 CC49(一种抗 TAG-72 抗体),两天后再注射低质量剂量的 IV 共注射,其中含有 2.5μg 的 (90)Y-cMORF 和 2.5μg 的 (99m)Tc-cMORF。在放射性注射后 3 小时,用 SPECT/CT 相机对 (99m)Tc 的分布进行成像,然后取出器官并计数 (90)Y 和 (99m)Tc。由于两种标记的 cMORF 在体内不反应或相互作用,因此两组 (90)Y 和 (99m)Tc 数据可以进行常规的组间比较。在一项新的研究中,计算了 (90)Y/(99m)Tc 比值。对于这两种方法都进行了学生 t 检验和回顾性功效分析。在新方法中,将 (90)Y/(99m)Tc 比值设定为 1 作为零假设。
常规组方法中的学生 t 检验表明,两种标记的 cMORF 分布相似,但唾液腺和大肠有显著差异。共注射-比值方法肯定没有颠覆常规方法的结果,但揭示了更细微的差异。P 值降低,大多数器官的功效增加,观察到更多显著差异。灵敏度的提高是由于 (90)Y/(99m)Tc 比值的 CV%(SD/平均值*100%)降低。因此,一些个体差异得到了规避,特别是比值方法将个体差异分为比值可纠正和比值不可纠正。
尽管常规方法是可靠的,但使用器官水平比值的共注射-比值方法更敏感,因此只要可能,建议使用该方法。此外,它将个体差异分为“共注射可纠正”和“共注射不可纠正”。