68Ga-NOTA-PRGD2 PET/CT for Integrin Imaging in Patients with Lung Cancer

This study was designed to assess the diagnostic value of 68Ga-NOTA-PRGD2 (NOTA-PRGD2 is NOTA-PEG4-E[c(RGDfK)](2)) PET/CT in lung cancer. Methods: Ninety-one patients (48 men and 43 women; age, 22-82 y) with suspected lung lesions on CT were enrolled with informed consent. Immediately after intravenous injection of 117.7 +/- 37.7 MBq of Ga-68-NOTA-PRGD2, 15 patients underwent dynamic whole-body PET/CT scans for 1-2 h, and the remaining 76 patients underwent whole-body PET/CT scans at 30 +/- 10 min after bolus injection. Each patient also underwent standard F-18-FDG PET/CT for comparison. Results: No side effect was found after Ga-68-NOTA-PRGD2 injection. Ga-68-NOTA-PRGD2 was rapidly cleared from the blood pool and primarily excreted through the urinary system. The standardized uptake values of proven malignancies were significantly higher than those of the benign ones. With an average standardized uptake value of greater than 1.3 being considered malignant, the sensitivity, specificity, and accuracy of Ga-68-NOTA-PRGD2 PET/CT in diagnosing lung cancer were 83.8% (57/68), 91.3%(21/23), and 85.7%(78/91), respectively. The diagnostic value of Ga-68-NOTA-PRGD2 for lung cancer is comparable to that of F-18-FDG PET/CT. However, Ga-68-NOTA-PRGD2 PET/CT is more specific than F-18-FDG PET/CT in assessing lymph node metastasis, with positive and negative predictive values of 90.0% (27/30) and 93.8% (121/129), respectively, whereas those of F-18-FDG PET/CT were 30.2% (29/96) and 90.5% (57/63), respectively. Conclusion: This study indicates the efficacy of Ga-68-NOTA-PRGD2 PET/CT in lung cancer diagnosis. 68Ga-NOTA-PRGD2 PET/CT shows significant advantage over F-18-FDG PET/CT in judging metastatic lymph nodes with higher specificity.