Can an ¹⁸F-ALF-NOTA-PRGD2 PET/CT Scan Predict Treatment Sensitivity to Concurrent Chemoradiotherapy in Patients with Newly Diagnosed Glioblastoma?

Abstract

This study examined the value of a novel 1-step labeled integrin α v β 3 -targeting 18 F-AlF-NOTA-PRGD2 (denoted as 18 F-RGD) scan in assessing sensitivity to concurrent chemoradiotherapy (CCRT) in patients with newly diagnosed glioblastoma multiforme (GBM). Methods: Twenty-five patients with newly diagnosed GBM were enrolled in this study 3-5 wk after surgical resection. All participants were investigated with 18 F-RGD PET/CT on baseline (T1) and at the third week (T2) after the start of CCRT. Tumor volume, maximal and mean standardized uptake value of the tumor (SUV max , SUV mean ), and tumor-to-nontumor ratios of the tumor volume were obtained. The MRI treatment response was assessed at the 11th week (T3). The change in the lesion volume from T1 to T3 on MRI was used as an endpoint to evaluate the predictive ability of 18 F-RGD PET/CT. Results: With 18 F-RGD PET/CT imaging, we successfully visualized the residual lesions of GBM. Twenty-five and 23 18 F-RGD PET/CT scans at baseline and the third week, respectively, were available for analysis. We found that 18 F-RGD PET/CT parameters, both pretreatment SUV max on baseline (P , 0.05) and intratreatment SUV max at the third week (SUV maxT2 ) (P , 0.05) and tumor-to-nontumor ratios at the third week (P , 0.05), were predictive of treatment sensitivity to CCRT. Additionally, the change of volume from T1 to T2 on MRI was also predictive (P , 0.05). According to receiver-operating-characteristic curve analysis, the most significant parameter was SUV maxT2 (area under the curve, 0.846). The threshold of SUV maxT2 was 1.35, and its sensitivity, specificity, and accuracy were 84.6%, 90.0% and 87.0%, respectively. Conclusion: 18 F-RGD PET/CT allows for the noninvasive visualization of GBM lesions and the prediction of sensitivity to CCRT as early as 3 wk after treatment initiation.

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

“…Recently, our team had performed a pilot clinical study in which 18 F-alfatide PET/CT parameters could predict the tumor sensitivity to CCRT in patients with glioma. Both baseline SUV max and intra-treatment SUV max showed correlations with response to CCRT, with the lesion volume change determined by MRI as the “gold” standard [14]. …”

“…A novel one-step labeled integrin αvβ3-targeting PET probe, 18 F-AlF-NOTA-PRGD2 (denoted as 18 F-alfatide) has been proved to be safe [12] and can identify lung cancer clearly with desirable image contrast [13]. We had performed a pilot clinical study in which 18 F-alfatide PET/CT parameters could predict the tumor sensitivity to CCRT in patients with glioma [14]. Therefore, we think 18 F-alfatide PET/CT might be a potential tool for predicting the short-term outcome of CCRT in patients with advanced NSCLC.…”

PET for Therapy Response Assessment in Glioblastoma

“…A novel labeled integrin α v β 3 -targeting 18 F-AIF-NOTA-PRGD2 ( 18 F-RGD) tracer showed positive results in assessing sensitivity to concurrent chemoradiotherapy in GB. An example is given in Figure 2G (44,26). Another approach was published by Oborski et al, suggesting the ability to image therapy-induced tumor cellular apoptosis using 18 F-2-(5-fluoro-pentyl)-2-methyl-malonic acid ( 18 F-ML-10) for early therapy response assessment of a newly diagnosed GB patient (127).…”

Editorial European Journal of Nuclear Medicine and Molecular Imaging

“…In the first clinical studies, 18 F-alfatide-PET allowed specific imaging of αvβ3 expression in lung cancers with good contrast [14]. Additionally, it appeared that 18 F-alfatide-PET/CT parameters can predict tumor sensitivity to CCRT in patients with glioma [15]. From the 18 F-alfatide-PET/CT study, described in this European Journal of Nuclear Medicine and Molecular Imaging’s issue, it appeared that the maximum standardized uptake value (SUV max ) , SUV peak , T/NT lung , T/NT blood , and T/NT muscle were higher in non-responders than responders and that 18 F-alfatide PET/CT might be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC.…”