Nuklearmedizin 2019; 58(02): 165
DOI: 10.1055/s-0039-1683652
Poster
PET und SPECT: Onkologie
Georg Thieme Verlag KG Stuttgart · New York

First-in-human study of a novel somatostatin receptor antagonist Ga-68-NODAGA-LM3 for PET imaging in paraganglioma patients

A Singh
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
J Zhang
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
HR Kulkarni
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
C Schuchardt
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
RP Baum
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2019 (online)

 
 

    Ziel/Aim:

    This study aims to analyze the safety and biodistribution of the SSTR antagonist Ga-68-NODAGA-LM3 (LM3 = p-Cl-Phe-cyclo(D-Cys-Tyr-D-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)D-Tyr-NH2) in comparison with the SSTR agonist Ga-68-DOTATOC, and to assess the diagnostic utility in paraganglioma patients.

    Methodik/Methods:

    Ten paraganglioma patients (7 male; age 35 – 66y, mean age 48.4 ± 11.0 y) were recruited after written informed consent. All patients underwent whole-body PET/CT scans at 45 – 55 min after intravenous injection of Ga-68-NODAGA-LM3. Ga-68-TOC PET/CT had been performed before (n = 6) or after (n = 4) LM3 PET/CT for a head-to-head comparison as well as CT and MRI. 7/10 patients were also studied by F-18-FDG and/or F-18-DOPA PET/CT. ROI were drawn manually over major organs. Tumor-to-background ratios (TBR) were calculated for the corresponding LM3 and TOC studies.

    Ergebnisse/Results:

    Ga-68-LM3 was well tolerated in all patients, no adverse efferts were noticed. The comparative physiological uptake of Ga-68-LM3 to Ga-68-TOC in the liver, spleen, kidneys, red marrow were 5.55 ± 1.57 vs. 9.73 ± 2.30, 20.47 ± 6.93 vs. 31,14 ± 7.50, 12.88 ± 4.57 vs. 10.28 ± 2.02 and 1.16 ± 0.36 vs. 0.98 ± 0.49. Ga-68-LM3 PET/CT showed positive findings in 10/10 patients with SUVmax of 53.78 ± 183.2 (2.51 – 299.95). Compared with TOC, LM3 detected more (243:177) lesions including (27:18) lymph nodes, (11:3) liver and (190:143) bone metastases and also demonstrated higher renal tracer accumulation. With normal tissue as background, LM3 associated TBR were TL-liver 15.7, LL (liver metastases)-liver 5.1, TL-kidney 6.8, TL-spleen 5.4, TL-red marrow 84.9, TL-gluteus 156.5, respectively.

    Schlussfolgerungen/Conclusions:

    This first in human study demonstrates safety and very high diagnostic accuracy of the new SSTR antagonist Ga-68-NODAGA-LM3 for imaging of SSTR positive paragangliomas. It provides a favorable biodistribution and was superior to the SSTR agonist in detecting tumor lesions, especially in the liver (due to the distinctively higher TBR) and in the skeletal system. The results emphasize the potential of the SSTR antagonist Ga-68-NODAGA-LM3 for diagnosis and for guiding SSTR-targeted therapy (theranostics) of paraganglioma patients.


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