Evaluation of Lung Cancer and Neuroendocrine Neoplasm in a Single Scan by Targeting Both Somatostatin Receptor and Integrin αvβ3

Purpose This pilot study aimed to prove the complementary value of a novel (68)Gallium-labeled heterodimeric peptide, Ga-68-NOTA-3P-TATE-RGD, in detection and evaluation of tumors with somatostatin receptor subtype 2 or integrin alpha(v)beta(3) overexpression, including non-small cell lung cancer (NSCLC), small-cell lung cancer (SCLC), neuroendocrine tumor (NET), and neuroendocrine carcinoma (NEC). Methods With institute review board approval and written informed consent, 32 patients with pathologically diagnosed lung cancer (18 NSCLC, 14 SCLC) and 12 patients with neuroendocrine neoplasm (8 NET, 4 NEC) patients were recruited to undergo Ga-68-NOTA-3P-TATE-RGD PET/CT. For comparison, the NSCLC patients also underwent Ga-68-NOTA-TATE PET/CT, the SCLC patients underwent Ga-68-NOTA-RGD PET/CT, and the neuroendocrine neoplasm patients underwent F-18-FDG PET/CT within 3 days. The maximum standardized uptake value (SUV) of the primary tumor (T) and mean SUV of the blood pool (B) were measured, and the T/B ratios were calculated for comparison. Results In the primary tumors of NSCLC, the T/B ratios of Ga-68-NOTA-3P-TATE-RGD were significantly higher than those of Ga-68-NOTA-TATE (4.54 +/- 3.00 versus 4.10 +/- 2.83, P = 0.0058). In SCLC, the T/B ratios of Ga-68-NOTA-3P-TATE-RGD were significantly higher than those of Ga-68-NOTA-RGD (6.06 +/- 6.09 versus 2.65 +/- 1.19, P = 0.0344). In NET, the T/B ratios of Ga-68-NOTA-3P-TATE-RGD were 36.13 +/- 33.84, significantly higher than those of F-18-FDG (2.91 +/- 1.71, P = 0.0234). In NEC, there were no significant difference between the T/B ratios of Ga-68-NOTA-3P-TATE-RGD (4.80 +/- 0.85) and those of F-18-FDG (3.56 +/- 0.74, P = 0.1833). Conclusions This proof-of-concept study preliminarily demonstrates the efficacy of the dual targeting Ga-68-NOTA-3P-TATE-RGD PET/CT in the evaluation of lung cancer and neuroendocrine neoplasm in a single scan.