新型RGD肽探针^18F-阿法肽对乳腺癌的诊断价值

Diagnostic value of a novel RGD-peptide based tracer ^18F-Alfatide Ⅱ for breast cancer

目的研究^18F-阿法肽(Alfatide Ⅱ)在乳腺病变患者体内的生物学分布,并与^18F-脱氧葡萄糖(FDG)分布作比较。方法前瞻性纳入2015年12月至2017年5月的44例可疑乳腺癌女性患者[(50.7±8.0)岁]。患者在治疗前行^18F-Alfatide Ⅱ、^18F-FDG PET/CT显像,对其体内正常器官和乳腺病灶勾画感兴趣区,比较^18F-Alfatide Ⅱ和^18F-FDG的分布差异。采用配对t检验、两样本t检验和Wilcoxon秩和检验比较数据。结果44例患者共53个乳腺病灶经组织病理学确诊,其中乳腺癌42个,乳腺良性病变11个。脑皮质、声带、肺、血池、肌肉的^18F-Alfatide Ⅱ摄取很低,肾皮质、膀胱^18F-Alfatide Ⅱ分布很多,包括正常乳腺在内的其余正常器官具有不同程度的^18F-Alfatide Ⅱ摄取。除脉络丛、唾液腺、肝脏、结肠、正常乳腺外,其他体内正常器官的^18F-Alfatide Ⅱ和^18F-FDG最大标准摄取值(SUVmax)和平均标准摄取值(SUVmean)均存在差异(t值:2.04~41.65,均P<0.05)。乳腺癌的^18F-Alfatide Ⅱ摄取低于^18F-FDG(SUVmax:3.77±1.78和7.37±4.48,SUVmean:2.25±0.98和4.54±2.82;t值:4.89、4.82,均P<0.05),但仍高于乳腺良性病变的^18F-Alfatide Ⅱ摄取(SUVmax:2.37±1.62,SUVmean:1.50±0.92;t值:2.35、2.29,均P<0.05)。乳腺癌^18F-Alfatide Ⅱ PET/CT显像靶/非靶(T/NT)也高于乳腺良性病变(5.32±3.08与2.60±2.37;t=2.72,P<0.05)。结论^18F-Alfatide Ⅱ在患者体内具有良好的生物学分布特征,适合用于乳腺癌显像。

Objective To investigate the biodistribution of ^18F-Alfatide Ⅱ in patients with breast diseases and to compare its uptake with ^18F-fluorodeoxyglucose (FDG) uptake. Methods A total of 44 female patients (age:(50.7±8.0) years) with clinically suspected breast cancer from December 2015 to May 2017 were prospectively enrolled and underwent ^18F-Alfatide Ⅱ and ^18F-FDG PET/CT prior to treatment. By drawing regions of interest in normal organs and breast lesions, differences between ^18F-Alfatide Ⅱ uptake and ^18F-FDG uptake were evaluated in all patients. Paired t test, two-sample t test and Wilcoxon rank sum test were used for data analysis. Results There were 53 breast lesions confirmed by histopathology in 44 patients. Among them, 42 lesions were malignant and the others were benign. The uptake of ^18F-Alfatide Ⅱ was very low in the brain, vocal cords, lungs, blood pool and muscle. But the renal cortex and bladder had high ^18F-Alfatide Ⅱ accumulation. Different levels of ^18F-Alfatide Ⅱ uptake were found in other normal organs including normal breast tissue. There were differences (t values: 2.04-41.65, all P<0.05) between ^18F-Alfatide Ⅱ and ^18F-FDG maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean) in many normal organs except for the choroid plexus, salivary glands, liver, colon and normal breast tissue. The uptake of ^18F-Alfatide Ⅱ was significantly lower than ^18F-FDG in breast cancer lesions (SUVmax: 3.77±1.78 vs 7.37±4.48, SUVmean: 2.25±0.98 vs 4.54±2.82;t values: 4.89, 4.82, both P<0.05), but it was still higher in benign breast lesions (SUVmax: 2.37±1.62, SUVmean: 1.50±0.92;t values: 2.35, 2.29, both P<0.05). Also, target/non-target (T/NT) of ^18F -Alfatide Ⅱ in breast cancer lesions was higher than that in benign breast lesions (5.32±3.08 vs 2.60±2.37;t=2.72, P<0.05). Conclusion The biodistribution of ^18F-Alfatide Ⅱ in patients is favorable and ^18F-Alfatide Ⅱ can be clinically used for breast cancer imaging.