Xiaoyi Guo, Jiayue Liu, Shiyu Lin, Xinyu Gui, Jin Ding, Teli Liu, Nina Zhou, Suping Li, Hua Zhu, Zhi Yang
{"title":"Al18F-NOTA-HER2-BCH PET对her2阳性乳腺癌患者淋巴结转移的检测","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 Al 18 F-NOTA-HER2-BCH and 18 F-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 Al 18 F-NOTA-HER2-BCH and 18 F-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 SUV max 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 Al 18 F-NOTA-HER2-BCH and 18 F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al 18 F-NOTA-HER2-BCH. Seven participants with high uptake only on 18 F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al 18 F-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 18 F-FDG PET/CT. Additionally, Al 18 F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18 F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUV max and TBR of regional or nonregional nodal metastases at Al 18 F-NOTA-HER2-BCH were all higher than those on 18 F-FDG (range of median SUV max , 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>Al 18 F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18 F-FDG PET/CT, especially for lesions small than 10 mm.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"381-387"},"PeriodicalIF":9.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Detectability of Al 18 F-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 Al 18 F-NOTA-HER2-BCH and 18 F-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 Al 18 F-NOTA-HER2-BCH and 18 F-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 SUV max 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 Al 18 F-NOTA-HER2-BCH and 18 F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al 18 F-NOTA-HER2-BCH. Seven participants with high uptake only on 18 F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al 18 F-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 18 F-FDG PET/CT. Additionally, Al 18 F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18 F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUV max and TBR of regional or nonregional nodal metastases at Al 18 F-NOTA-HER2-BCH were all higher than those on 18 F-FDG (range of median SUV max , 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>Al 18 F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18 F-FDG PET/CT, especially for lesions small than 10 mm.</p>\",\"PeriodicalId\":10692,\"journal\":{\"name\":\"Clinical Nuclear Medicine\",\"volume\":\" \",\"pages\":\"381-387\"},\"PeriodicalIF\":9.6000,\"publicationDate\":\"2025-05-01\",\"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\":\"2025/1/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","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":"2025/1/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究的目的是比较Al18F-NOTA-HER2-BCH和18F-FDG在PET/CT上检测her2阳性乳腺癌患者淋巴结转移的效果。患者和方法：在这项回顾性研究中，62名her2阳性乳腺癌患者接受了Al18F-NOTA-HER2-BCH和18F-FDG PET/CT检查。参与者病理证实为her2阳性（IHC 3+或IHC 2+， FISH基因扩增）。三位独立的阅读者目测成像示踪剂的摄取情况。此外，使用c-statistics评估结节转移的诊断准确性。用SUVmax和靶背景比（TBR）量化病灶摄取，并用一般线性混合模型进行比较。结果：研究结果显示33例（53%）参与者出现淋巴结转移，其中45%仅为区域淋巴结转移，55%为非区域淋巴结转移。在每例患者水平上，基于多数读数的Al18F-NOTA-HER2-BCH和18F-FDG的敏感性和特异性分别为0.97、0.97和0.85、0.77。5名参与者仅在Al18F-NOTA-HER2-BCH上可见。7例仅18F-FDG PET/CT高摄取的患者，经病理结果及后期影像学随访证实为炎性摄取。在每个病灶水平上，Al18F-NOTA-HER2-BCH PET/CT比18F-FDG PET/CT检测到更多的腋窝（98.8%比70.2%）、腋窝外（100%比61.7%）和非区域（99.1%比67.0%）淋巴结转移。此外，Al18F-NOTA-HER2-BCH PET/CT比18F-FDG PET/CT检出更多小于10 mm的淋巴结转移（198 vs 125, 99.5% vs 62.8%）。Al18F-NOTA-HER2-BCH组的中位SUVmax和TBR均高于18F-FDG组(中位SUVmax范围，8.0-11.4 vs 2.3-5.6；结论：与18F-FDG PET/CT相比，Al18F-NOTA-HER2-BCH PET/CT在her2阳性乳腺癌患者中检测到更多的区域和非区域淋巴结转移，尤其是小于10 mm的病灶。
Detectability of Al 18 F-NOTA-HER2-BCH PET for Nodal Metastases in Patients With HER2-Positive Breast Cancer.
Purpose: The aim of this study was to compare Al 18 F-NOTA-HER2-BCH and 18 F-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 Al 18 F-NOTA-HER2-BCH and 18 F-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 SUV max 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 Al 18 F-NOTA-HER2-BCH and 18 F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al 18 F-NOTA-HER2-BCH. Seven participants with high uptake only on 18 F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al 18 F-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 18 F-FDG PET/CT. Additionally, Al 18 F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18 F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUV max and TBR of regional or nonregional nodal metastases at Al 18 F-NOTA-HER2-BCH were all higher than those on 18 F-FDG (range of median SUV max , 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: Al 18 F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18 F-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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