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Theranostics 2015; 5(10):1115-1121. doi:10.7150/thno.12938 This issue Cite

Research Paper

Pilot Prospective Evaluation of ¹⁸F-Alfatide II for Detection of Skeletal Metastases

Baoming Mi^1#, Chunjing Yu^1#, Donghui Pan², Min Yang^2✉, Weixing Wan^1✉, Gang Niu^3✉, Xiaoyuan Chen^3✉

1. Department of Nuclear Medicine, Affiliated Hospital of Jiangnan University (Wuxi 4^th People's Hospital), Wuxi, China
2. Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, China
3. Laboratory of Molecular Imaging and Nanomedicine, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA
#Contributed equally to this work

✉ Corresponding authors: Weixing Wan (wwxjscom); Min Yang (ymzfkcom.hk); Gang Niu (niugnih.gov); Xiaoyuan Chen (shawn.chengov)

Abstract

This pilot prospective evaluation study is to verify the efficiency of ¹⁸F-Alfatide II, a specific PET imaging agent for integrin αvβ3, in detecting bone metastasis in human, with comparison to ¹⁸F-FDG PET. Thirty recruited patients underwent ¹⁸F-FDG and ¹⁸F-alfatide II PET/CT successively within days. The final diagnosis of bone lesions was established based on the comprehensive assessment of all available data and clinical follow-up, which fall into four groups: osteolytic, osteoblastic, mixed and bone marrow. Visual analysis and quantification of SUV_max were performed to compare the detection sensitivity of ¹⁸F-Alfatide II and ¹⁸F-FDG PET. Eleven patients were found to have a total of 126 bone metastasis lesions. ¹⁸F-Alfatide II PET can detect the bone metastatic lesions with good contrast and higher sensitivity (positive rate of 92%) than ¹⁸F-FDG PET (77%). Especially, ¹⁸F-Alfatide II PET showed superiority to ¹⁸F-FDG PET in detecting osteoblastic (70% vs. 53%) and bone marrow metastatic lesions (98% vs. 77%). In conclusion, ¹⁸F-Alfatide II PET/CT can be used to detect skeletal and bone marrow metastases, with nearly 100% sensitivity in osteolytic, mixed and bone marrow lesions. The sensitivity of ¹⁸F-Alfatide II PET/CT in osteoblastic metastases is relatively low but still significantly higher than that of ¹⁸F-FDG PET/CT. This pilot clinical study warrants the further application of ¹⁸F-Alfatide II PET/CT in metastatic lesion detection, patient management and drug therapy response monitoring.

Keywords: RGD peptide, Alfatide II, FDG, PET/CT, bone metastasis

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