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European Journal of Nuclear Medicine and Molecular Imaging

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01-12-2011 | Original Article

Differential diagnosis of solitary pulmonary nodules using ^99mTc-3P₄-RGD₂ scintigraphy

Authors: Qingjie Ma, Bin Ji, Bing Jia, Shi Gao, Tiefeng Ji, Xueju Wang, Zhenguo Han, Guoqing Zhao

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2011

Abstract

Purpose

Targeting of integrin α_νβ₃ with molecular imaging agents offers great potential in early detection and monitoring of tumour angiogenesis. Recently, an RGD (Arg-Gly-Asp) tracer, ^99mTc-3P₄-RGD₂, with high affinity to integrin α_νβ₃ and in vivo tumour uptake was developed. In this study, we evaluate the feasibility of this novel radiotracer in the noninvasive differentiation of solitary pulmonary nodules (SPNs).

Methods

Twenty-one patients with SPNs on CT were studied scintigraphically after administration of ^99mTc-3P₄-RGD₂ with a dose of 939 ± 118 MBq. Image interpretation using a 5-point scale was performed by one thoracic radiologist for CT and three nuclear medicine radiologists for single photon emission computed tomography (SPECT). Scintigraphic images were also analysed semiquantitatively by calculating tumour to normal tissue ratio (T/N). The “gold standard” was based on the histopathological diagnosis of the surgical samples from all recruited patients. A fraction of the samples were analysed immunohistochemically for integrin α_vβ₃ expression.

Results

Among the 21 SPNs, 15 (71%) were diagnosed as malignant and 6 (29%) were benign. The mean size for SPNs was 2.2 ± 0.6 cm. The sensitivity and specificity for CT interpretation, SPECT visual and semiquantitative analysis were 80/67%, 100/67% and 100/67%, respectively. All SPNs classified as indeterminate by CT were correctly diagnosed by ^99mTc-3P₄-RGD₂ scintigraphy. The empirical receiver-operating characteristic (ROC) areas were 0.811 [95% confidence interval (CI) 58–95%] for CT, 0.833 (95% CI 61–96%) for SPECT and 0.844 (95% CI 62–96%) for T/N ratios, respectively. Immunohistochemistry confirmed α_νβ₃ expression in malignant and benign nodules with uptake in ^99mTc-3P₄-RGD₂ scintigraphy.

Conclusion

In this first-in-human study, we demonstrated the feasibility of using ^99mTc-3P₄-RGD₂ scintigraphy in differentiating SPNs. This procedure appears to be highly sensitive in detection of malignant SPNs. SPECT visual analysis seems to be sufficient for characterization of SPNs.

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Title: Differential diagnosis of solitary pulmonary nodules using 99mTc-3P4-RGD2 scintigraphy
Authors: Qingjie Ma
Bin Ji
Bing Jia
Shi Gao
Tiefeng Ji
Xueju Wang
Zhenguo Han
Guoqing Zhao
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2011
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1901-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Differential diagnosis of solitary pulmonary nodules using ^99mTc-3P₄-RGD₂ scintigraphy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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