18F-alfatide PET/CT may predict short-term outcome of concurrent chemoradiotherapy in patients with advanced non-small cell lung cancer

Abstract

PurposeThe study aims to investigate the role of 18F-alfatide positron emission tomography/computed tomography (PET/CT) in predicting the short-term outcome of concurrent chemoradiotherapy (CCRT) in patients with advanced non-small cell lung cancer (NSCLC).MethodsEighteen patients with advanced NSCLC had undergone 18F-alfatide PET/CT scans before CCRT and PET/CT parameters including maximum and mean standard uptake values (SUVmax/SUVmean), peak standard uptake values (SUVpeak) and tumor volume (TVPET and TVCT) were obtained. The SUVmax of tumor and normal tissues (lung, blood pool and muscle) were measured, and their ratios were denoted as T/NT (T/NTlung, T/NTblood and T/NTmuscle). Statistical methods included the Two-example t test, Wilcoxon rank-sum test, Receiver-operating characteristic (ROC) curve analysis and logistic regression analyses.ResultsWe found that SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were higher in non-responders than in responders (P = 0.0024, P = 0.016, P < 0.001, P = 0.003, P = 0.004). According to ROC curve analysis, the thresholds of SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were 5.65, 4.46, 7.11, 5.41, and 11.75, respectively. The five parameters had high sensitivity, specificity and accuracy in distinguishing non-responders and responders. Multivariate logistic regression analyses showed that T/NTlung was an independent predictor of the short-term outcome of CCRT in patients with advanced NSCLC (P = 0.032).Conclusions 18F-alfatide PET/CT may be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC.

18F‑alfatide positron emission tomography may predict anti‑angiogenic responses

“…Subsequently, it was further confirmed that changes in 18 F-FPPRGD 2 uptake as early as 1 week after bevacizumab administration may be able to predict the outcome of treatment in patients with cervical and ovarian cancer (21). However, all these results were completely contrary to the results of a previous study (14), which demonstrated that tumor uptake in 18 F-alfatide PET/CT was higher in non-responders than in responders following CCRT. In the present study, the correlation between tumor uptake prior to treatment and the degree of treatment response in the bevacizumab groups was higher than that in the apatinib groups.…”

“…It is presumed that it is more difficult for chemotherapeutic drugs and oxygen to reach a tumor with increased immature tumor neovascularization. This may be the reason why tumor uptake in 18 F-alfatide PET/CT prior to treatment was higher in non-responders than in responders (P<0.01) (13,14). The negative association between tumor uptake of 18 F-alfatide prior to treatment and the degree of the chemoradiotherapy response may reduce the treatment-response association of bevacizumab to a moderate one in the bevacizumab combined with chemotherapy group.…”

“…Intratumor angiogenic heterogeneity (CV) also existed among the groups and was higher in the A549 group than in the PC-3 group. RGD-based tracer targeting of αvβ3 has already been used in the diagnosis of malignant tumors (10,26,27) and in predicting the efficacy of CCRT in NSCLC (13,14). Low 68 Ga-RGD 2 uptake and poor αvβ3 expression in SCLC may have led to the conclusion that αvβ3-targeted therapy is not adequate for the majority of SCLC patients.…”

“…Animal experiments have shown that 18 F-alfatide PET is an effective tracer for tumor spatial heterogeneity imaging (12), allowing further investigation of the angiogenic heterogeneity among different tumors. In addition, we have performed two pilot clinical studies in which 18 F-alfatide PET/CT parameters were found to predict tumor sensitivity to concurrent chemoradiation therapy (CCRT) in patients with gliomas and advanced non-small cell lung cancer (NSCLC) (13,14). Therefore, we hypothesized that 18 F-alfatide PET may be able to predict anti-angiogenic responses.…”

Recent Advances in 18F Radiochemistry: A Focus on B-18F, Si-18F, Al-18F, and C-18F Radiofluorination via Spirocyclic Iodonium Ylides

“…Seventeen patients with lung cancer were accurately identified among true-negative (hamartoma) as well as false-positive (chronic inflammation and inflammatory pseudotumor) cases. The question of whether 18 F-alfatide PET/CT imaging can predict the short-term outcome of concurrent chemoradiotherapy in patients with advanced non-small cell lung cancer was investigated by Luan et al (26). Responders and nonresponders to chemotherapy could be distinguished with high sensitivity, specificity, and accuracy, confirming that 18 F-alfatide could be a useful tool in therapy response prediction.…”