Research ArticleClinical Investigations

99mTc-3PRGD2 for Integrin Receptor Imaging of Lung Cancer: A Multicenter Study

Zhaohui Zhu, Weibing Miao, Qianwei Li, Haojie Dai, Qingjie Ma, Feng Wang, Aiming Yang, Bing Jia, Xiaona Jing, Sha Liu, Jiyun Shi, Zhaofei Liu, Zhoushe Zhao, Fan Wang and Fang Li
Journal of Nuclear Medicine May 2012, 53 (5) 716-722; DOI: https://doi.org/10.2967/jnumed.111.098988

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Negative and positive whole-body scans of 99mTc-3PRGD2. (A–D) Anterior and posterior whole-body images at 1 h (A and B) and 4 h (C and D) of 75-y-old man with low 99mTc-3PRGD2 uptake in chronic inflammation lesion at right upper lung (T/B, 1.1) and enlarged lymph nodes in mediastinum. (E–H) Anterior and posterior whole-body images at 1 h (E and F) and 4 h (G and H) of 57-y-old woman with lung adenocarcinoma at right middle lobe (T/B, 2.4), accompanied by mediastinal and left supraclavicular lymph node involvement and extensive bone metastases.

  • FIGURE 2.
    FIGURE 2.

    True- and false-positive 99mTc-3PRGD2 SPECT/CT scans. (A–C) CT (A), SPECT (B), and fusion (C) images of 71-y-old woman with moderate differentiated squamous cell carcinoma showing intense 99mTc-3PRGD2 accumulation near hilus of left upper lung (arrow), accompanied by distal obstructive atelectasis with mild uptake (cross). (D–F) CT (D), 99mTc-3PRGD2 SPECT (E), and 18F-FDG PET (F) images of 53-y-old man with tuberculosis granuloma at right upper lung. 99mTc-3PRGD2 SPECT image showed moderate uneven uptake at lesion, with possible central necrosis (cross) and mild to moderate uptake in bone marrow, whereas 18F-FDG PET image showed intense uptake of lesion.

  • FIGURE 3.
    FIGURE 3.

    Comparison of T/B and T/M ratios (mean ± SD) of benign and malignant lesions between whole-body (WB) planar and SPECT images obtained at 1 and 4 h, respectively.

Tables

  • TABLE 1

    SPECT Systems and Recruited Patient Number of 6 Participant Centers

    CentersSPECT systemRecruited patients
    The First Affiliated Hospital of Fujian Medical University, FuzhouInfinia Hawkeye, GE Healthcare19
    Peking Union Medical College Hospital, Beijing (the organizer center)Precedence 16, Philips Healthcare17
    Southwest Hospital of the Third Military Medical University, ChongqingMillennium MPR, GE Healthcare12
    Beijing Tongren Hospital, BeijingInfinia Hawkeye4, GE Healthcare11
    China-Japan Union Hospital, ChangchunSkylight, Philips Healthcare9
    The First Affiliated Hospital of Xi’an Jiaotong University, Xi’anInfinia VC Hawkeye4, GE Healthcare2
  • TABLE 2

    Basic Information on Patients

    Sex
    DiagnosisNumberMaleFemaleAge (y)
    Malignant58441463 ± 9
     Adenocarcinoma2315864 ± 10
     Squamous cell carcinoma2422263 ± 10
     Small cell lung cancer21153, 61
     Adenocarcinoma plus small cell lung cancer11066
     Bronchioloalveolar carcinoma10158
     Sarcoma11068
     Melanoma11057
     Lung malignancy, type undefined53265 ± 8
    Benign125762 ± 11
     Chronic inflammation63361 ± 9
     Granuloma of tuberculosis10153
     Fungal infection11070
     Adenoma10169
     Sclerosing hemangioma11078
     Mature cystic teratoma10143
     Arteriovenous malformation with inflammation10170
    Total70492163 ± 9

    • Data are mean ± SD.

  • TABLE 3

    Efficacy of 99mTc-3PRGD2 Imaging for Diagnosis of Primary Lung Cancer

    AnalysisTime (h)ModeCriteria for positivitySensitivity (%)Specificity (%)Accuracy (%)Positive predictive value (%)Negative predictive value (%)
    Semiquantitative1PlanarT/B > 1.28867849353
    SPECTT/B > 1.58858839150
    4PlanarT/B > 1.47260709126
    SPECTT/B > 1.97262708933
    Visual1Planar*9358879264
    SPECT*9758909278
    4Planar*9867939389
    SPECT*9867939389

    • ↵* Higher than soft tissue, but also considered volume effect, necrosis, and metastasis.

    • Data are for analysis of lung lesions in 70 patients (malignant, 58; benign, 12).

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