Miao Weibing, Zheng Shan, Dai Haojie, Wang Feng, Jin Xiaona, Zhu Zhaohui, Jia Bing
Department of Nuclear Medicine, the 1st Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Nuclear Medicine, Beijing Tongren Hospital, Beijing, China.
PLoS One. 2014 Oct 22;9(10):e111221. doi: 10.1371/journal.pone.0111221. eCollection 2014.
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.
The 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.
A 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.
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.
ClinicalTrials.gov NCT01737112.
99mTc-3PRGD2是一种有前景的靶向整合素受体的示踪剂，可作为单光子发射计算机断层扫描（SPECT）的新型肿瘤特异性显像剂。一项多中心研究前瞻性设计，旨在评估99mTc-3PRGD2显像对肺癌患者骨转移的诊断准确性，并与传统的99mTc-MDP骨扫描进行比较。
患者静脉注射11.1MBq/Kg 99mTc-3PRGD2后1小时和4小时先后进行全身扫描和胸部断层扫描。99mTc-MDP全身骨扫描在1周内常规进行以作比较。三位经验丰富的核医学医师对99mTc-3PRGD2和99mTc-MDP图像进行盲法判读。最终诊断基于对所有可用数据的综合评估。
从4个中心招募了44例疑似肺癌患者（男性29例，年龄59±10岁）。18例患者中的89处骨病变被诊断为转移瘤，9例患者中的23处骨病变为良性。在基于病变的分析中，99mTc-3PRGD2显像的灵敏度、特异度和准确度分别为92.1%、91.3%和92.0%。在同一患者中，99mTc-MDP骨扫描的相应诊断值分别为87.6%、60.9%和82.1%。99mTc-MDP骨扫描在大多数病变中对比度更好，而99mTc-3PRGD2显像似乎在排除假阳性病变和检测无成骨的骨转移方面更有效。
99mTc-3PRGD2是基于SPECT技术的新型肿瘤特异性显像剂，在肺癌患者骨转移诊断中具有良好的应用价值。
ClinicalTrials.gov NCT01737112。
