Diagnostic Potential of 68Ga-NeoB PET/CT with Estrogen Receptor– and Progesterone Receptor–Positive Breast Cancer Undergoing Staging or Restaging for Metastatic Disease

Zahra Sabahi, Andrew Nguyen, Keith Wong, Sherrington Li, Nathan Papa, Elgene Lim, Rachel F. Dear, Alexander M. Menzies, Frances Boyle, Yoland Antill, Belinda E. Kiely, Benjamin C. Forster, Cindy Mak, Diana Adams, Lina Pugliano, Andrew Spillane, Shikha Sharma, Adam Hickey, Aron Poole, Shikha Agrawal, Sobia Khan, Narjess Ayati, Louise Emmett
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Abstract

18F-FDG PET/CT has low sensitivity for estrogen receptor and progesterone receptor (ER/PR)–positive breast cancer. By contrast, gastrin-releasing peptide receptor is overexpressed in ER/PR-positive breast cancer. This study assessed the diagnostic potential of 68Ga-NeoB PET/CT in staging or restaging metastatic ER/PR-positive and human epidermal growth factor receptor 2 (HER2)–negative breast cancer. Methods: Patients with ER/PR-positive and HER2-negative breast cancer with clinical suspicion for metastatic disease undergoing staging or restaging were prospectively enrolled. All patients underwent 68Ga-NeoB PET/CT, in addition to standard 18F-FDG PET/CT. ER/PR-positive and HER2-negative status was confirmed in prior biopsy samples (primary or metastatic). Conventional imaging (18F-FDG PET/CT, bone scan, and diagnostic CT) was required within 3 wk of 68Ga-NeoB PET/CT. 18F-FDG PET/CT and 68Ga-NeoB PET/CT were assessed visually and quantitatively. Visually, all scans were read masked by 2 readers, with a third reader if results were discordant. Results: Twenty patients were enrolled, all with ER/PR-positive and HER2-negative histopathology. Of these, 75% (15/20) had lobular-subtype cancer, 40% (8/20) had suspected metastatic disease at diagnosis, and 60% (12/20) underwent restaging after systemic therapy. Overall, 75% (15/20) of the 68Ga-NeoB PET/CT scans and 65% (13/20) of the 18F-FDG PET/CT scans were positive on visual assessment. For 50% (10/20) of patients, both scans were positive, and for 10% (2/20) of patients, both scans were negative. In the staging group, 75% (6/8) of patients had positive 68Ga-NeoB PET/CT and 50% (4/8) of patients had positive 18F-FDG PET/CT. At restaging, 75% (9/12) of patients had positive 68Ga-NeoB PET/CT and 75% (9/12) of patients had positive 18F-FDG PET/CT. Sites of positive 68Ga-NeoB PET/CT and negative 18F-FDG PET/CT disease were identified in 50% (4/8) of staging patients and 42% (5/12) of restaging patients, whereas negative 68Ga-NeoB PET/CT and positive 18F-FDG PET/CT disease was found in none of the staging patients but 58% (7/12) of the restaging cohort. Of these, 71% (5/7) of patients had a reduction in their ER status in the most recent biopsy samples. Quantitatively, the median SUVmax was higher for 68Ga-NeoB PET/CT (20.5; interquartile range, 5.8–31.3) than for 18F-FDG PET/CT (7.4; interquartile range, 4.9–9.8). Conclusion: 68Ga-NeoB PET/CT has diagnostic potential in the staging of ER/PR-positive and HER2-negative breast cancer. Further evaluation is warranted.

68Ga-NeoB PET/CT对雌激素受体和孕激素受体阳性乳腺癌转移性疾病分期或再分期的诊断潜力
18F-FDG PET/CT对雌激素受体和孕激素受体(ER/PR)阳性乳腺癌敏感性低。相比之下,胃泌素释放肽受体在ER/ pr阳性乳腺癌中过度表达。本研究评估了68Ga-NeoB PET/CT在转移性ER/ pr阳性和人表皮生长因子受体2 (HER2)阴性乳腺癌分期或再分期中的诊断潜力。方法:前瞻性纳入临床怀疑有转移性疾病的ER/ pr阳性和her2阴性乳腺癌患者进行分期或再分期。除标准18F-FDG PET/CT外,所有患者均行68Ga-NeoB PET/CT检查。ER/ pr阳性和her2阴性状态在先前的活检样本中得到证实(原发性或转移性)。68Ga-NeoB PET/CT术后3周内需进行常规影像学检查(18F-FDG PET/CT、骨扫描、诊断性CT)。对18F-FDG PET/CT和68Ga-NeoB PET/CT进行视觉定量评估。视觉上,所有扫描被2个读取器屏蔽,如果结果不一致,则使用第三个读取器。结果:20例患者入组,均为ER/ pr阳性和her2阴性组织病理学。其中,75%(15/20)患有小叶亚型癌,40%(8/20)在诊断时怀疑有转移性疾病,60%(12/20)在全身治疗后进行了重新分期。总体而言,75%(15/20)的68Ga-NeoB PET/CT扫描和65%(13/20)的18F-FDG PET/CT扫描的视觉评估呈阳性。50%(10/20)的患者两次扫描均为阳性,10%(2/20)的患者两次扫描均为阴性。分期组68Ga-NeoB PET/CT阳性75% (6/8),18F-FDG PET/CT阳性50%(4/8)。再分期时,75%(9/12)的患者为68Ga-NeoB PET/CT阳性,75%(9/12)的患者为18F-FDG PET/CT阳性。在50%(4/8)的分期患者和42%(5/12)的再分期患者中发现了68Ga-NeoB PET/CT阳性和18F-FDG PET/CT阴性的部位,而在分期患者中没有发现68Ga-NeoB PET/CT阴性和18F-FDG PET/CT阳性的部位,但在再分期队列中发现了58%(7/12)。其中,71%(5/7)的患者在最近的活检样本中其ER状态有所降低。定量上,68Ga-NeoB PET/CT的中位SUVmax更高(20.5;四分位数范围,5.8-31.3)比18F-FDG PET/CT (7.4;四分位数范围4.9-9.8)。结论:68Ga-NeoB PET/CT对ER/ pr阳性和her2阴性乳腺癌分期有诊断价值。需要进一步的评价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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