Lee Inki, Byun Byung Hyun, Kim Byung Il, Choi Chang Woon, Kang Hye Jin, Kang Chi Soo, Woo Sang-Keun, Lee Kyo Chul, Kang Joo Hyun, Lim Ilhan
Department of Nuclear Medicine, .
Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital and .
Nucl Med Commun. 2024 Oct 1;45(10):865-873. doi: 10.1097/MNM.0000000000001889. Epub 2024 Aug 19.
This study aimed to evaluate the biodistribution of 64 Cu-DOTA-rituximab and its diagnostic feasibility for lymphoma using CD20-targeted 64 Cu-DOTA-rituximab PET/computed tomography (PET/CT).
A prospective study involving six patients diagnosed with lymphoma was conducted between January 2022 and January 2023. These patients underwent 18 F-fluorodeoxyglucose ( 18 F-FDG) and 64 Cu-DOTA-rituximab PET/CT scans. 64 Cu-DOTA-rituximab PET/CT images were acquired at 1, 24, and 48 h after administering 64 Cu-DOTA-rituximab to assess the biodistribution and dosimetry over time. The observed lymph nodes were categorized into specific regions, including cervical and supraclavicular, axillary and infraclavicular, mediastinal, hilar, abdominal paraaortic and retroperitoneal, iliac, mesenteric, and inguinal regions, to compare the diagnostic ability of 18 F-FDG and 64 Cu-DOTA-rituximab PET/CT in detecting lymphoma lesions. Furthermore, the tumor-to-background ratio was calculated and compared with the maximum standardized uptake (SUV max ) of the tumors and the mean standardized uptake (SUV mean ) of normal organs. Internal radiation dosimetry was determined using the OLINDA/EXM software.
64 Cu-DOTA-rituximab uptake in lymph nodes associated with lymphoma progressively increased from 1 to 48 h after injection. In contrast, 64 Cu-DOTA-rituximab uptake in normal organs, such as blood, lung, kidney, bladder, muscle, bone, and brain, decreased over time, whereas it increased in the liver and spleen. When it comes to the comparison between 64 Cu-DOTA-rituximab and 18 F-FDG, the SUV max of tumors was higher on 64 Cu-DOTA-rituximab PET/CT (18.1 ± 8.3) than on 18 F-FDG PET/CT (5.2 ± 1.5). Additionally, the tumor-to-background ratio, measured using the SUV mean of normal muscles, was higher on 64 Cu-DOTA-rituximab PET/CT (55.7 ± 31.0) than on 18 F-FDG PET/CT (8.6 ± 2.8). No adverse events related to 64 Cu-DOTA-rituximab injection were reported.
The results of this study demonstrate the feasibility of using 64 Cu-DOTA-rituximab PET/CT to evaluate the CD20 expression. The increased 64 Cu-DOTA-rituximab uptake in lymph nodes associated with tumors, higher SUV max , and tumor-to-muscle ratios observed with 64 Cu-DOTA-rituximab PET/CT compared with 18 F-FDG PET/CT, highlight the diagnostic potential of this imaging modality.
本研究旨在使用靶向CD20的64Cu-DOTA-利妥昔单抗正电子发射断层显像/计算机断层扫描（PET/CT）评估64Cu-DOTA-利妥昔单抗的生物分布及其对淋巴瘤的诊断可行性。
2022年1月至2023年1月对6例诊断为淋巴瘤的患者进行了一项前瞻性研究。这些患者接受了18F-氟脱氧葡萄糖（18F-FDG）和64Cu-DOTA-利妥昔单抗PET/CT扫描。在注射64Cu-DOTA-利妥昔单抗后的1、24和48小时采集64Cu-DOTA-利妥昔单抗PET/CT图像，以评估随时间变化的生物分布和剂量学。将观察到的淋巴结分为特定区域，包括颈部和锁骨上、腋窝和锁骨下、纵隔、肺门、腹主动脉旁和腹膜后、髂部、肠系膜和腹股沟区域，以比较18F-FDG和64Cu-DOTA-利妥昔单抗PET/CT检测淋巴瘤病变的诊断能力。此外，计算肿瘤与本底比值，并与肿瘤的最大标准化摄取值（SUVmax）和正常器官的平均标准化摄取值（SUVmean）进行比较。使用OLINDA/EXM软件确定内照射剂量学。
注射后1至48小时，与淋巴瘤相关的淋巴结中64Cu-DOTA-利妥昔单抗摄取量逐渐增加。相比之下，正常器官如血液、肺、肾、膀胱、肌肉、骨骼和大脑中的64Cu-DOTA-利妥昔单抗摄取量随时间减少，而肝脏和脾脏中的摄取量增加。在64Cu-DOTA-利妥昔单抗与18F-FDG的比较中，64Cu-DOTA-利妥昔单抗PET/CT上肿瘤的SUVmax（18.1±8.3）高于18F-FDG PET/CT上的（5.2±1.5）。此外，使用正常肌肉的SUVmean测量的肿瘤与本底比值，64Cu-DOTA-利妥昔单抗PET/CT上（55.7±31.0）高于18F-FDG PET/CT上的（8.6±2.8）。未报告与64Cu-DOTA-利妥昔单抗注射相关的不良事件。
本研究结果证明了使用64Cu-DOTA-利妥昔单抗PET/CT评估CD20表达的可行性。与18F-FDG PET/CT相比，64Cu-DOTA-利妥昔单抗PET/CT观察到肿瘤相关淋巴结中64Cu-DOTA-利妥昔单抗摄取增加、SUVmax更高以及肿瘤与肌肉比值更高，突出了这种成像方式的诊断潜力。
