^(68)Ga-NOTA-3P-TATE-RGD PET/CT在神经内分泌肿瘤中的应用  

Application of ^(68)Ga-NOTA-3P-TATE-RGD PET/CT in the evaluation of neuroendocrine neoplasms

作　　者：蒋媛媛 郑玉民[2] 朱朝晖 Jiang Yuanyuan;Zheng Yumin;Zhu Zhaohui(Department of Nuclear Medicine(PET/CT Center),National Cancer Center/National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,China;Nuclear Medicine Department,China-Japan Friendship Hospital,Beijing 100029,China;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,State Key Laboratory of Complex Severe and Rare Diseases,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,Beijing 100730,China)

机构地区：[1]国家癌症中心、国家肿瘤临床医学研究中心、中国医学科学院肿瘤医院核医学科(PET/CT中心),北京100021 [2]中日友好医院核医学科,北京100029 [3]中国医学科学院、北京协和医学院北京协和医院核医学科、疑难重症及罕见病全国重点实验室、核医学分子靶向诊疗北京市重点实验室,北京100730

出　　处：《中华核医学与分子影像杂志》2023年第11期649-654,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(82272046)。

摘　　要：目的探讨同时靶向生长抑素受体(SSTR)和整合素αvβ3的新型双靶点分子探针68Ga-1,4,7-三氮杂环壬烷-1,4,7-三乙酸-3聚乙二醇-D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽-精氨酸-甘氨酸-天冬氨酸(NOTA-3P-TATE-RGD)PET/CT显像用于神经内分泌肿瘤(NEN)的价值。方法前瞻性纳入2021年4月至2022年2月间北京协和医院的35例经病理证实的NEN患者[男19例、女16例,中位年龄54(41,61)岁],所有患者在1周内行68Ga-NOTA-3P-TATE-RGD和68Ga-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸-D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽(DOTATATE)PET/CT显像。采用Wilcoxon符号秩检验比较2种显像检出的病灶数目、SUV_(max)和肿瘤/本底比值(TBR)的差异。结果68Ga-NOTA-3P-TATE-RGD和68Ga-DOTATATE PET/CT显像检出的病灶总数分别为1190和1106个,两者均检出35个原发肿瘤,对淋巴结转移灶[4(1,8)和4(1,8)个;z=-0.45,P=0.655]及骨转移灶[5(2,60)和5(2,66)个;z=-1.11,P=0.244]的检测能力相当,但68Ga-NOTA-3P-TATE-RGD检出的肝转移灶数量明显多于68Ga-DOTATATE[(17(6,27)和8(3,26)个;z=-2.31,P=0.021]。肿瘤的68Ga-DOTATATE摄取程度明显高于68Ga-NOTA-3P-TATE-RGD摄取[SUV_(max):15.6(9.9,24.9)和12.7(8.0,18.4);z=-7.19,P<0.001],但肝转移灶68Ga-DOTATATE显像明显较68Ga-NOTA-3P-TATE-RGD显像的TBR低[3.4(1.8,5.5)和6.1(3.8,10.8);z=-7.56,P<0.001]。结论68Ga-NOTA-3P-TATE-RGD对NEN肝转移灶的检出能力优于68Ga-DOTATATE,而对于其他部位病灶的检出能力与68Ga-DOTATATE相当。Objective To investigate the value of PET/CT imaging with ^(68)Ga-1,4,7-triazacyclononane-1,4,7-triacetic acid-3 polyethylene glycol-D-Phe1-Tyr3-Thr8-octreotide Arg-Gly-Asp(NOTA-3P-TATE-RGD),a dual somatostatin receptor 2-and integrinαvβ3-targeting tracer,in the evaluation of neuroendocrine neoplasms(NEN).Methods From April 2021 to February 2022,35 patients(19 males,16 females;median age 54(41,61)years)with histologically confirmed NEN in Peking Union Medical College Hospital were prospectively enrolled.All patients were scanned with both ^(68)Ga-NOTA-3P-TATE-RGD and ^(68)Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide(DOTATATE)PET/CT imaging within one week.The differences of the numbers of detected lesions,SUV_(max) and tumor-to-background ratio(TBR)between the two imaging methods were compared by Wilcoxon signed-rank test.Results Of the 35 patients,the total numbers of lesions detected by ^(68)Ga-NOTA-3P-TATE-RGD and ^(68)Ga-DOTATATE were 1190 and 1106,respectively.^(68)Ga-NOTA-3P-TATE-RGD and ^(68)Ga-DOTATATE both detected 35 primary tumors and performed comparably in detecting lymph node metastases(4(1,8)vs 4(1,8);z=-0.45,P=0.655)and bone metastases(5(2,60)vs 5(2,66);z=-1.11,P=0.244).However,the number of liver lesions detected by ^(68)Ga-NOTA-3P-TATE-RGD was significantly higher than that by ^(68)Ga-DOTATATE(17(6,27)vs 8(3,26);z=-2.31,P=0.021).^(68)Ga-DOTATATE demonstrated higher SUV_(max) than ^(68)Ga-NOTA-3P-TATE-RGD(15.6(9.9,24.9)vs 12.7(8.0,18.4);z=-7.19,P<0.001),while the TBR of liver metastases was significantly lower(3.4(1.8,5.5)vs 6.1(3.8,10.8);z=-7.56,P<0.001).Conclusion ^(68)Ga-NOTA-3P-TATE-RGD performs better than ^(68)Ga-DOTATATE in the detection of liver metastases,while is comparable to ^(68)Ga-DOTATATE in detecting lesions of other sites.

关 键 词：神经内分泌瘤 受体 肽 有机金属化合物 镓放射性同位素 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R739.4[医药卫生—肿瘤]