Abstract
626
Purpose: 18F-Alfatide (18F-ALF-NOTA-PRGD2, denoted as 18F-Alfatide) is an integrin αvβ3-specific tracer developed for positron emission tomography (PET) imaging. The present study investigated the feasibility of PET/computed tomography (CT) imaging using 18F-Alfatide and assessed the effectiveness of 18F-Alfatide PET/CT versus other staging modalities for determining tumor length in cases ofesophageal squamous cell carcinoma (ESCC).
Methods: Twenty-nine patients with newly diagnosed ESCC underwent 18F-Alfatide PET/CT scanning within 1 week before surgery, and 14 of these patients also underwent 18F-FDG PET/CT scanning. Standardized uptake values (SUVs) were determined by region-of-interest analysis. The lengthof the primary lesion was determined by the PET/CT techniques as well as enhanced CT, upper gastrointestinal series (UGIS), and endoscopy. All results were compared with measurements of the resected specimen.Correlations between the measurements obtained using the different methods were analyzed.
Results: The 18F-FDG SUVs were higher than the 18F -Alfatide SUVs for esophageal tumors as well as most normal tissues and organs, except for the spleen, liver, and kidney. The tumor-to-blood and tumor-to-lung ratios from 18F-Alfatide PET/CT were significantly higher than those from18F-FDG PET/CT (P<0.001). The mean tumor lengths obtained by 18F-Alfatide PET/CT, 18F-FDG PET/CT, UGIS, CT, endoscopy, and measurement of the resected specimen were 4.11±0.96 cm, 4.28±1.10 cm, 3.69±1.19 cm,4.02±1.08 cm, 3.57±1.13 cm, and 4.26±1.25 cm, respectively, and the corresponding correlation coefficients for each measurement relative tothe resected specimen measurement were 0.860, 0.890, 0.661, 0.610, and 0.744, respectively. The tumor lengths obtained by 18F-Alfatide PET/CT and 18F-FDG PET/CT did not differ significantly from those obtained for the resected specimens (P =0.229 and P=0.06, respectively).
Conclusions: 18F-Alfatide is an effective tracer for esophageal tumor detection and measurement on PET/CT, with similar efficacy to 18F-FDG and more advantages than traditional methods such as CT, UGIS and endoscopy.18F-Alfatide PET/CT may be a valuable supplement or alternativeto 18F-FDG PET/CT, particularly for patients with diabetes.