Passah Averilicia, Tripathi Madhavi, Ballal Sanjana, Yadav Madhav Prasad, Kumar Rajeev, Roesch Frank, Meckel Marian, Sarathi Chakraborty Partha, Bal Chandrasekhar
Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Nuclear Chemistry, Johannes-Gutenberg-University, Mainz, Germany.
Eur J Nucl Med Mol Imaging. 2017 Jan;44(1):41-49. doi: 10.1007/s00259-016-3469-3. Epub 2016 Jul 25.
The successful labelling of bisphosphonates (BP) with Ga using macrocyclic chelators such as the based triazacyclononane (NO2AP) is a step forward in the in-house availability of a novel bone-seeking PET radiopharmaceutical with dual advantage of PET/CT imaging and generator production. In this study, we compared the novel generator-based skeletal radiotracer Ga-1,4,7-triazacyclonone-1,4-diacetic acid (Ga-NO2AP-BP) with sodium fluoride (F-NaF) for the detection of skeletal metastases in breast cancer patients. In addition, dosimetric analysis of Ga-NO2AP-BP was performed in a subset of patients.
This was a prospective study of histopathologically proven cases of breast cancer patients who were referred for bone scintigraphy and underwent positron emission tomography/computed tomography (PET/CT) with F-NaF and Ga-NO2AP-BP within a week in random order. The scans of each patient were compared both qualitatively for image quality and quantitatively for number of lesions and SUVmax of lesions. Dosimetric analysis was performed in five patients. Their PET/CT scans were acquired at multiple time points and urine and blood samples were collected. Dosimetric calculations were performed using OLINDA/EXM 1.1 software. Statistical analysis was done using Stata 13 (StataCorp) software package. An agreement analysis regarding number of lesions detected with the two skeletal radiotracers was carried out.
The image quality of Ga-NO2AP-BP PET/CT scans were comparable to that of F-NaF. There was no statistically significant difference in the SUVmax of lesions, normal bone and lesion to background ratio between the two skeletal radiotracers. There was good agreement in the number of lesions detected by both skeletal radiotracers. The mean whole body effective dose for Ga-NO2AP-BP was 0.00583 mSv/MBq and the effective dose equivalent was 0.0086 mSv/MBq.
The excellent lesion detection agreement between Ga-NO2AP-BP and F-NaF favours the former as an alternative for skeletal scintigraphy in centres without an on-site cyclotron. The favourable dosimetric results and its potential to be used as a theranostic agent makes it an important generator-based skeletal radiotracer.
使用大环螯合剂（如基于三氮杂环壬烷（NO2AP））成功地用镓标记双膦酸盐（BP），是朝着在内部获得一种具有PET/CT成像和发生器生产双重优势的新型骨靶向PET放射性药物迈出的一步。在本研究中，我们比较了新型基于发生器的骨放射性示踪剂镓-1,4,7-三氮杂环壬烷-1,4-二乙酸（Ga-NO2AP-BP）与氟化钠（F-NaF）在检测乳腺癌患者骨转移方面的效果。此外，还对部分患者进行了Ga-NO2AP-BP的剂量学分析。
这是一项对组织病理学证实的乳腺癌患者进行的前瞻性研究，这些患者被转诊进行骨闪烁扫描，并在一周内随机顺序接受了使用F-NaF和Ga-NO2AP-BP的正电子发射断层扫描/计算机断层扫描（PET/CT）。对每位患者的扫描图像进行了定性的图像质量比较和定量的病变数量及病变SUVmax比较。对五名患者进行了剂量学分析。在多个时间点采集他们的PET/CT扫描图像，并收集尿液和血液样本。使用OLINDA/EXM 1.1软件进行剂量学计算。使用Stata 13（StataCorp）软件包进行统计分析。对两种骨放射性示踪剂检测到的病变数量进行了一致性分析。
Ga-NO2AP-BP PET/CT扫描的图像质量与F-NaF相当。两种骨放射性示踪剂在病变的SUVmax、正常骨以及病变与背景比值方面均无统计学显著差异。两种骨放射性示踪剂检测到的病变数量有良好的一致性。Ga-NO2AP-BP的平均全身有效剂量为0.00583 mSv/MBq，有效剂量当量为0.0086 mSv/MBq。
Ga-NO2AP-BP与F-NaF在病变检测方面的出色一致性，使得前者在没有现场回旋加速器的中心成为骨闪烁扫描的替代选择。有利的剂量学结果及其作为治疗诊断剂的潜力使其成为一种重要的基于发生器的骨放射性示踪剂。
