Clinical Evaluation of 68Ga-FAPI-RGD for Imaging of Fibroblast Activation Protein and Integrin αvβ3 in Various Cancer Types.

IF 9.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Nuclear Medicine Pub Date : 2023-08-01 DOI:10.2967/jnumed.122.265383
Liang Zhao, Xuejun Wen, Weizhi Xu, Yizhen Pang, Long Sun, Xiaoming Wu, Pengfei Xu, Jingjing Zhang, Zhide Guo, Qin Lin, Xiaoyuan Chen, Haojun Chen
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引用次数: 8

Abstract

Radiolabeled fibroblast activation protein (FAP) inhibitors (FAPIs) and Arg-Gly-Asp (RGD) peptides have been extensively investigated for imaging of FAP- and integrin αvβ3-positive tumors. In this study, a FAPI-RGD heterodimer was radiolabeled with 68Ga and evaluated in patients with cancer. We hypothesized that the heterodimer, recognizing both FAP and integrin αvβ3, would be advantageous because of its dual-receptor-targeting property. Methods: The effective dose of 68Ga-FAPI-RGD was evaluated in 3 healthy volunteers. The clinical feasibility of 68Ga-FAPI-RGD PET/CT was evaluated in 22 patients with various types of cancer, and the results were compared with those of 18F-FDG and 68Ga-FAPI-46. Results: 68Ga-FAPI-RGD was tolerated well, with no adverse events in any of the healthy volunteers or patients. The effective dose from 68Ga-FAPI-RGD PET/CT was 1.01 × 10-2 mSv/MBq. In clinical investigations with different types of cancer, the radiotracer uptake and tumor-to-background ratio (TBR) of primary and metastatic lesions in 68Ga-FAPI-RGD PET/CT were significantly higher than those in 18F-FDG PET/CT (primary tumors: SUVmax, 18.0 vs. 9.1 [P < 0.001], and TBR, 15.2 vs. 5.5 [P < 0.001]; lymph node metastases: SUVmax, 12.1 vs. 6.1 [P < 0.001], and TBR, 13.3 vs. 4.1 [P < 0.001]), resulting in an improved lesion detection rate and tumor delineation, particularly for the diagnosis of lymph node (99% vs. 91%) and bone (100% vs. 80%) metastases. 68Ga-FAPI-RGD PET/CT also yielded a higher radiotracer uptake and TBR than 68Ga-FAPI-46 PET/CT did. Conclusion: 68Ga-FAPI-RGD exhibited improved tumor uptake and TBR compared with 18F-FDG and 68Ga-FAPI PET/CT. This study demonstrated the safety and clinical feasibility of 68Ga-FAPI-RGD PET/CT for imaging of various types of cancer.

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68Ga-FAPI-RGD对不同类型肿瘤成纤维细胞活化蛋白和整合素αvβ3成像的临床评价
放射性标记的成纤维细胞活化蛋白(FAP)抑制剂(FAPIs)和arg - gy - asp (RGD)肽已被广泛研究用于FAP和整合素αvβ3阳性肿瘤的成像。在本研究中,FAPI-RGD异源二聚体用68Ga进行放射性标记,并在癌症患者中进行评估。我们假设,同时识别FAP和整合素αvβ3的异源二聚体将是有利的,因为它具有双受体靶向特性。方法:对3名健康志愿者进行68Ga-FAPI-RGD有效剂量测定。对22例不同类型肿瘤患者进行68Ga-FAPI-RGD PET/CT的临床可行性评估,并与18F-FDG和68Ga-FAPI-46的结果进行比较。结果:68Ga-FAPI-RGD耐受性良好,所有健康志愿者和患者均无不良事件发生。68Ga-FAPI-RGD PET/CT有效剂量为1.01 × 10-2 mSv/MBq。在不同类型肿瘤的临床研究中,68ga - fpi - rgd PET/CT对原发和转移灶的示踪剂摄取和肿瘤/背景比(TBR)均显著高于18F-FDG PET/CT(原发肿瘤:SUVmax, 18.0 vs. 9.1 [P < 0.001], TBR, 15.2 vs. 5.5 [P < 0.001];淋巴结转移:SUVmax, 12.1 vs. 6.1 [P < 0.001], TBR, 13.3 vs. 4.1 [P < 0.001]),导致病变检出率和肿瘤描绘提高,特别是对于淋巴结(99% vs. 91%)和骨(100% vs. 80%)转移的诊断。68Ga-FAPI-RGD PET/CT也比68Ga-FAPI-46 PET/CT产生更高的放射性示踪剂摄取和TBR。结论:与18F-FDG和68Ga-FAPI PET/CT相比,68Ga-FAPI- rgd具有更好的肿瘤摄取和TBR。本研究验证了68Ga-FAPI-RGD PET/CT对各种类型肿瘤成像的安全性和临床可行性。
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来源期刊
Journal of Nuclear Medicine
Journal of Nuclear Medicine 医学-核医学
CiteScore
13.00
自引率
8.60%
发文量
340
审稿时长
1 months
期刊介绍: The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.
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