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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2020

Open Access 01-04-2020 | Idiopathic Pulmonary Fibrosis | Original Article

Clinical quantification of the integrin αvβ6 by [18F]FB-A20FMDV2 positron emission tomography in healthy and fibrotic human lung (PETAL Study)

Authors: Pauline T. Lukey, Christopher Coello, Roger Gunn, Christine Parker, Frederick J. Wilson, Azeem Saleem, Nadia Garman, Maria Costa, Stuart Kendrick, Mayca Onega, Arthur R. Kang’ombe, Allan Listanco, James Davies, Joaquim Ramada-Magalhaes, Sara Moz, William A. Fahy, Toby M. Maher, Gisli Jenkins, Jan Passchier, Richard P. Marshall

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2020

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Abstract

Purpose

The RGD-integrin, αvβ6, plays a role in the pathogenesis of pulmonary fibrosis through activation of transforming growth factor beta (TGFβ). This study sought to quantify expression of αvβ6 in the lungs of healthy humans and subjects with pulmonary fibrosis using the αvβ6-selective [18F]FB-A20FMDV2 PET ligand.

Methods

[18F]FB-A20FMDV2 PET/CT scans were performed in healthy subjects and those with fibrotic lung disease. Standard uptake values (SUV) and volume of distribution (VT) were used to quantify αvβ6 expression. In subjects with fibrotic lung disease, qualitative assessment of the relationship between αvβ6 expression and the distribution of fibrosis on high resolution computed tomography was conducted.

Results

A total of 15 participants (6 healthy, 7 with idiopathic pulmonary fibrosis (IPF) and 2 with connective tissue disease (CTD) associated PF) were enrolled. VT and SUV of [18F]FB-A20FMDV2 were increased in the lungs of subjects with pulmonary fibrosis (PF) compared with healthy subjects. Geometric mean VT (95% CI) was 0.88 (0.60, 1.29) mL/cm3 for healthy subjects, and 1.40 (1.22, 1.61) mL/cm3 for subjects with IPF; and SUV was 0.54 (0.36, 0.81) g/mL for healthy subjects and 1.03 (0.86, 1.22) g/mL for subjects with IPF. The IPF/healthy VT ratio (geometric mean, (95% CI of ratio)) was 1.59 (1.09, 2.32) (probability ratio > 1 = 0.988)) and the SUV ratio was 1.91 (1.27, 2.87) (probability ratio > 1 = 0.996). Increased uptake of [18F]FB-A20FMDV2 in PF was predominantly confined to fibrotic areas. [18F]FB-A20FMDV2 measurements were reproducible at an interval of 2 weeks. [18F]FB-A20FMDV2 was safe and well tolerated.

Conclusions

Lung uptake of [18F]FB-A20FMDV2, a measure of expression of the integrin αvβ6, was markedly increased in subjects with PF compared with healthy subjects.
Appendix
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Metadata
Title
Clinical quantification of the integrin αvβ6 by [18F]FB-A20FMDV2 positron emission tomography in healthy and fibrotic human lung (PETAL Study)
Authors
Pauline T. Lukey
Christopher Coello
Roger Gunn
Christine Parker
Frederick J. Wilson
Azeem Saleem
Nadia Garman
Maria Costa
Stuart Kendrick
Mayca Onega
Arthur R. Kang’ombe
Allan Listanco
James Davies
Joaquim Ramada-Magalhaes
Sara Moz
William A. Fahy
Toby M. Maher
Gisli Jenkins
Jan Passchier
Richard P. Marshall
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04586-z

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