Xiaoyi Guo, Jiayue Liu, Shiyu Lin, Xinyu Gui, Jin Ding, Teli Liu, Nina Zhou, Suping Li, Hua Zhu, Zhi Yang
{"title":"Detectability of Al18F-NOTA-HER2-BCH PET for Nodal Metastases in Patients With HER2-Positive Breast Cancer.","authors":"Xiaoyi Guo, Jiayue Liu, Shiyu Lin, Xinyu Gui, Jin Ding, Teli Liu, Nina Zhou, Suping Li, Hua Zhu, Zhi Yang","doi":"10.1097/RLU.0000000000005686","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare Al18F-NOTA-HER2-BCH and 18F-FDG for detecting nodal metastases in patients with HER2-positive breast cancer on PET/CT.</p><p><strong>Patients and methods: </strong>In this retrospective study, 62 participants with HER2-positive breast cancer underwent both Al18F-NOTA-HER2-BCH and 18F-FDG PET/CT. Participants were pathologically confirmed as HER2-positive (IHC 3+ or IHC 2+ with gene amplification on FISH). Three independent readers visually assessed uptake of tracers on imaging. Furthermore, the diagnostic accuracy of nodal metastases was assessed using c-statistics. The lesion uptakes were quantified by SUVmax and target-to-background ratio (TBR) and compared using the general linear mixed model.</p><p><strong>Results: </strong>The findings showed nodal metastases in 33 (53%) participants, including 45% only with regional nodal metastasis and 55% with nonregional nodal metastasis. On per-patient level, the sensitivity and specificity of Al18F-NOTA-HER2-BCH and 18F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al18F-NOTA-HER2-BCH. Seven participants with high uptake only on 18F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al18F-NOTA-HER2-BCH PET/CT detected more axillary (98.8% vs 70.2%), extra-axillary (100% vs 61.7%), and nonregional (99.1% vs 67.0%) lymph nodal metastases than 18F-FDG PET/CT. Additionally, Al18F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUVmax and TBR of regional or nonregional nodal metastases at Al18F-NOTA-HER2-BCH were all higher than those on 18F-FDG (range of median SUVmax, 8.0-11.4 vs 2.3-5.6; P range, <0.001-0.007; range of median TBR, 7.3-16.3 vs 2.9-5.3; P range, <0.001). No adverse reactions related to imaging agents were observed in all participants.</p><p><strong>Conclusions: </strong>Al18F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18F-FDG PET/CT, especially for lesions small than 10 mm.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RLU.0000000000005686","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The aim of this study was to compare Al18F-NOTA-HER2-BCH and 18F-FDG for detecting nodal metastases in patients with HER2-positive breast cancer on PET/CT.
Patients and methods: In this retrospective study, 62 participants with HER2-positive breast cancer underwent both Al18F-NOTA-HER2-BCH and 18F-FDG PET/CT. Participants were pathologically confirmed as HER2-positive (IHC 3+ or IHC 2+ with gene amplification on FISH). Three independent readers visually assessed uptake of tracers on imaging. Furthermore, the diagnostic accuracy of nodal metastases was assessed using c-statistics. The lesion uptakes were quantified by SUVmax and target-to-background ratio (TBR) and compared using the general linear mixed model.
Results: The findings showed nodal metastases in 33 (53%) participants, including 45% only with regional nodal metastasis and 55% with nonregional nodal metastasis. On per-patient level, the sensitivity and specificity of Al18F-NOTA-HER2-BCH and 18F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al18F-NOTA-HER2-BCH. Seven participants with high uptake only on 18F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al18F-NOTA-HER2-BCH PET/CT detected more axillary (98.8% vs 70.2%), extra-axillary (100% vs 61.7%), and nonregional (99.1% vs 67.0%) lymph nodal metastases than 18F-FDG PET/CT. Additionally, Al18F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUVmax and TBR of regional or nonregional nodal metastases at Al18F-NOTA-HER2-BCH were all higher than those on 18F-FDG (range of median SUVmax, 8.0-11.4 vs 2.3-5.6; P range, <0.001-0.007; range of median TBR, 7.3-16.3 vs 2.9-5.3; P range, <0.001). No adverse reactions related to imaging agents were observed in all participants.
Conclusions: Al18F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18F-FDG PET/CT, especially for lesions small than 10 mm.
期刊介绍：
Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty.
Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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