⁶⁸Ga-NOTA-NFB PET/CT for Imaging of Chemokine Receptor 4 Expression in Breast Cancer

Purpose: Our team used ⁶⁸Ga-NOTA-NFB in imaging glioma that over expresses Chemokine receptor-4 (CXCR4) by PET/CT, and got well results. So this time, we tried to use ⁶⁸Ga-NOTA-NFB in breast cancer which high expression CXCR4 like glioma. And the quality of receptors’ expression has correlation with poor survival. This study used a radiolabeled CXCR4 ligand ⁶⁸Ga-NOTA-NFB, and investigated CXCR4-directed imaging with positron emission tomography/computer tomography (PET/CT). in this research, we want to check whether the tracer suit for breast cancer or not, and the correlation with the pathological expression.

Methods: 11 patients with breast cancer (5 patients only have primary lesions, other 6 patient all have metastasis in lymph nodes and sum to 14) underwent ⁶⁸Ga-NOTA-NFB PET/CT to assess the expression of CXCR4 before surgery. ¹⁸F-FDG PET/CT images were available in all these 11 patients and visually and semi-quantitatively by using SUV_max. Tumor-to-background (TBR) were calculated for both tracers. ⁶⁸Ga-NOTA-NFB PET/CT results were also compared to pathological CXCR4 expression on the biopsy samples.

Results: The ¹⁸F-FDGimageshad been used as reference method, by imaging of ¹⁸F-FDG we obverse 11 primary, and 14 lymph nodes. ⁶⁸Ga-NOTA-NFB PET/CT was visually positive in 11/11 primary lesions with SUV_max of 3.78±2.03,and positive in 11/14 lymph nodes with SUV_max of 2.85±1.86. Respective values for ¹⁸F-FDG in primary lesions were 8.11±5.14 (SUV_max), and in lymph nodes were 4.82±4.12 (SUV_max). In primary lesions, TBR for SUV_max were little higher for ¹⁸F-FDG than ⁶⁸Ga-NOTA-NFB (t=-1.63, P=0.134), but have no difference in statistic. At the same time, TBR for SUV_max were respectively higher for ¹⁸F-FDG than ⁶⁸Ga-NOTA-NFB (t=-2.43, P=0.036) in lymph nodes. Pathological analysis confirmed CXCR4 expression in tissue with ⁶⁸Ga-NOTA-NFB uptakes, but the intensities were not correlation with the uptakes.

Conclusions: In this study, ⁶⁸Ga-NOTA-NFB has been confirmed can observe majority of breast cancer lesions as ¹⁸F-FDG. And it was a new tracer for no-invasive determination of CXCR4 expression, as well as may be used into selecting of patients those suit for CXCR4 therapy. [Key words]breast cancer; Positron-emission tomography; Tomography, X-ray computed; Gallium radioisotopes; chemokine receptor 4

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