Abstract
2211
Introduction: Different SSTR2 antagonists have been developed. This study aims to evaluate the impact of different peptides and chelators on the diagnostic performance of SSTR2 antagonists in well-differentiated NETs.
Methods: In this prospective study (ClinicalTrials.gov identifier: NCT04491851) conducted from October 2020 to April 2021, participants were equally randomized into two arms: Arm A, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the 1st day and 68Ga-DOTA-LM3 PET/CT scan on the 2nd day, Arm B, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the 1st day and 68Ga-NODAGA-JR11 PET/CT scan on the 2nd day. Biodistribution in normal organs, lesion detection ability, and tumor uptake were compared within each Arm using paired t test or nonparametric Wilcoxon matched-pair signed-rank.
Results: A total of 40 participants (age, 49.5 ± 13.4, 21 men) with well-differentiated NETs, 20 in each arm, were recruited in the study. In Arm A, 68Ga-DOTA-LM3 showed lower background, however, the lesion detection ability (overall lesion detected, 445 versus 548, P = 0.005) and lesion uptake (overall lesions SUVmax, 19.8 ± 17.2 versus 35.3 ± 28.8, P < 0.001) was significantly lower than that of 68Ga-NODAGA-LM3. In Arm B, both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 showed similar biodistribution and lesion uptake (SUVmax, 28.5 ± 23.8 versus 25.0 ± 20.0, P < 0.001) despite minor differences. The lesion detection ability was exactly the same between these two tracers (overall lesion detected, 503 versus 503).
Conclusions: Chelators, rather than peptides, play a major role in the diagnostic performance of SSTR2 antagonists. Both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 may outperform 68Ga-DOTA-LM3 with higher lesion uptake and detection ability, of which 68Ga-NODAGA-LM3 had marginally but significantly higher lesion uptake.
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