68Ga-NOTA-NFB PET/CT imaging in breast cancer: clinical study of a new targeted agent for chemokine receptor 4

Objective To investigate the clinical application of chemokine receptor 4 (CXCR4)-targeted PET/CT imaging in breast cancer using 68Ga-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid-TN14003(NOTA-NFB) and the correlation between 68Ga-NOTA-NFB uptake and pathology. Methods From June 2014 to December 2014, 11 female patients (age range: 38-68 years) with non-specific invasive breast cancer were recruited in this study. All patients underwent neoadjuvant chemotherapy before surgery. 68Ga-NOTA-NFB and 18F-fluorodeoxyglucose (FDG) PET/CT imaging were performed before the chemotherapy. Three patients also underwent 68Ga-NOTA-NFB PET/CT imaging after the fourth cycle of chemotherapy. The region of interest (ROI) method was used to measure the maximum standardized value (SUVmax) and tumor/non-tumor (T/NT) ratio was calculated. Paired t test and Spearman correlation analysis were used for statistical analysis. Results The SUVmax values of primary lesions were 3.78±2.03 and 8.11±5.14 (t=-3.01, P 0.05). In the metastatic lymph nodes, SUVmax values were not significantly different between 68Ga-NOTA-NFB imaging and 18F-FDG imaging (t=-2.02, P>0.05), but T/NT ratios were significantly different (t=-2.43, P<0.05). After neoadjuvant chemotherapy, T/NT ratios were decreased in the 3 patients. Correlation was not found between T/NT in 68Ga-NOTA-NFB imaging and Ki-67, but the P value was close to 0.05(rs=0.600, P=0.051). Conclusion 68Ga-NOTA-NFB PET/CT can be used as a new CXCR4-targered imaging in diagnosis of breast cancer, and it may be beneficial to evaluate the effect of neoadjuvant chemotherapy. Key words: Breast neoplasms; Photon-emission tomography; Tomography, X-ray computed; Gallium; Receptors, CXCR4