Department of Nuclear Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, China; and.
Nuclear Medicine Department, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
J Nucl Med. 2023 Sep;64(9):1406-1411. doi: 10.2967/jnumed.122.264890. Epub 2023 Jul 20.
The current study aimed to compare Ga-NODAGA-Cpa-cyclo(d-Cys-amino-Phe-hydroorotic acid-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)-d-Tyr-NH (JR11) and Ga-DOTATATE PET/CT in patients with metastatic, well-differentiated neuroendocrine tumors. A prospective bicenter study aimed at enrolling 100 patients with histologically proven, metastatic or unresectable, well-differentiated neuroendocrine tumors was conducted. The first 48 patients represented the study cohort. Each patient received Ga-DOTATATE on the first day and Ga-NODAGA-JR11 on the second day. Whole-body PET/CT scans were performed at 40-60 min after injection. Normal-organ uptake, lesion numbers, lesion uptake, and sensitivity were compared. The potential impact on clinical management was also determined. Overall, Ga-NODAGA-JR11 demonstrated lower background uptake in normal organs. Compared with Ga-DOTATATE, Ga-NODAGA-JR11 detected significantly more liver lesions (673 vs. 584, = 0.002). The target-to-background ratio of liver lesions was significantly higher on Ga-NODAGA-JR11 (6.4 ± 8.7 vs. 3.1 ±2.6, = 0.000). Comparable uptake was observed for primary tumors, bone lesions, and lymph node metastases. In total, 180 lesions were detected on conventional imaging in 15 patients; 165 and 139 lesions of them were positive on Ga-NODAGA-JR11 and Ga-DOTATATE, leading to a sensitivity of 91.7% and 77.2%, respectively. In 14.5% (7/48) of patients, Ga-NODAGA-JR11 PET might have a potential impact on clinical management. Ga-NODAGA-JR11 shows better sensitivity and a higher target-to-background ratio than Ga-DOTATATE. The detection of more lesions by the antagonist may have a potential impact on clinical management in a subgroup of patients.
本研究旨在比较 Ga-NODAGA-Cpa-cyclo(d-Cys-amino-Phe-hydroorotic acid-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)-d-Tyr-NH (JR11) 和 Ga-DOTATATE PET/CT 在转移性、分化良好的神经内分泌肿瘤患者中的应用。一项旨在招募 100 名经组织学证实的转移性或不可切除、分化良好的神经内分泌肿瘤患者的前瞻性双中心研究进行了。前 48 名患者为研究队列。每位患者在第一天接受 Ga-DOTATATE，第二天接受 Ga-NODAGA-JR11。注射后 40-60 分钟进行全身 PET/CT 扫描。比较了正常器官摄取、病变数量、病变摄取和敏感性。还确定了对临床管理的潜在影响。总的来说，Ga-NODAGA-JR11 在正常器官中的背景摄取较低。与 Ga-DOTATATE 相比，Ga-NODAGA-JR11 检测到的肝脏病变明显更多（673 个 vs. 584 个， = 0.002）。Ga-NODAGA-JR11 上肝脏病变的靶/背景比显著更高（6.4±8.7 vs. 3.1±2.6， = 0.000）。原发肿瘤、骨病变和淋巴结转移的摄取情况相似。共有 15 名患者在常规影像上检测到 180 个病灶；其中 165 个和 139 个病灶在 Ga-NODAGA-JR11 和 Ga-DOTATATE 上呈阳性，敏感性分别为 91.7%和 77.2%。在 48 名患者中的 14.5%（7/48），Ga-NODAGA-JR11 PET 可能对临床管理有潜在影响。Ga-NODAGA-JR11 的敏感性优于 Ga-DOTATATE，且靶/背景比更高。拮抗剂检测到更多的病变可能对某些患者的临床管理产生潜在影响。
