Abstract
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Purpose: To assess a novel radiotracer 18F-Aluminum fluoride-1,4,7-triazacyclononane-triacetic acid-pegylated dimeric RGD (18F-ALF-NOTA-PRGD2, denoted as18F-Alfatide) positron emission tomography (PET)/computed tomography (CT) & explore the relationship between clinicopathological characteristics & maximum standard uptake in primary (SUVP) & metastatic lymph nodes (SUVLN) in patients with esophageal squamous cell carcinoma (ESCC), verified by pathologic examination & compared with those using 2-deoxy-2-[18F]fluoro-D-glucose ([18F]DG).
Methods: Sixty-one patients with newly diagnosed esophageal cancer underwent 18F-Alfatide PET/CT (n=29) & [18F]DG PET/CT (n=32) scans before surgery within 3 days. SUVs, pathological tumor-node-metastasis (pTNM) stage of primary tumor & metastatic lymph nodes (LNs) were measured, & diagnoses were pathologically confirmed.
Results: Forty-six patients underwent curative surgery & PET/CT scans, including 18F-Alfatide (n=21) & [18F]DG (n=25). No significantly different SUVP of 18F-Alfatide PET/CT was observed among the cohorts based on gender, pathological stage, T stage, status of LN & differentiation, respectively, as well as [18F]DG PET/CT, P>0.05. A significant difference was observed in SUVLN between the pathological stages & status of LN both in 18F-Alfatide PET/CT (P were 0.03 & 0.003) & [18F]DG PET/CT (P were 0.001 & <0.001), but not in gender (P=0.128, 0.129), T stage (P=0.791, 0.727), or tumor differentiation (P=0.049, 0.053). Significant positive correlations between the SUVLN & pathological stage (r=0.52, P=0.016), status of LN (r=0.73, P<0.001), or differentiation (r=0.509, P<0.019) of 18F-Alfatide PET/CT were observed, & those of [18F]DG PET/CT were r=0.503, P=0.01; r=0.649, P<0.001; r=0.459, P=0.021, respectively. Relationships of SUVP between SUVLN, length, age, gender, pathological stage, T stage, status of LN, or differentiation, & of SUVLN between length, age, gender, or T stage had no statistical differences in either 18F-Alfatide PET/CT or [18F]DG PET/CT, P>0.05.
Conclusions: These findings suggest that SUVLN was influenced by pathological stage & LN status & differentiation. SUVLN may therefore serve as a new parameter for patient stratification with ESCC. 18F-Alfatide PET can provide complementary molecular information about ESCC metastasis.