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Evaluation of synovial angiogenesis in patients with rheumatoid arthritis using ??Ga-PRGD2 PET/CT: a prospective proof-of-concept cohort study.

ABSTRACT: The study aimed to evaluate the use of positron emission tomography/computed tomography (PET/CT) with (68)Ga-PRGD2 as the tracer for imaging of synovial angiogenesis in patients with rheumatoid arthritis (RA).Twenty untreated active patients with RA underwent (68)Ga-PRGD2 PET/CT and (18)F-FDG PET/CT before treatment; two patients with osteoarthritis served as controls. Among the 20 patients with RA, 12 repeated the evaluations after 3-month treatment. The image findings were correlated with core variables of disease activity, including the clinical disease activity index (cDAI).Our findings demonstrated that (68)Ga-PRGD2 specifically accumulated in the synovia with active inflammation rich in neovasculature with high-level ?v?3-integrin expression, but not in the (18)F-FDG-avid inflammatory lymph nodes. In patients with intense (18)F-FDG uptake in muscles caused by arthritic pain, we observed that (68)Ga-PRGD2 PET/CT was better able to evaluate disease severity than (18)F-FDG PET/CT. Both (68)Ga-PRGD2 accumulation and (18)F-FDG uptake changed in response to therapeutic intervention, whereas the changes of (68)Ga-PRGD2, not (18)F-FDG, significantly correlated with clinical measures of changes in the form of cDAI.This is the first integrin imaging study conducted in patients with RA that preliminarily indicates the effectiveness of the novel method for evaluating synovial angiogenesis.This study has been registered online at NIH ClinicalTrial.gov (NCT01940926).

SUBMITTER: Zhu Z

PROVIDER: S-EPMC4033145 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Evaluation of synovial angiogenesis in patients with rheumatoid arthritis using ⁶⁸Ga-PRGD2 PET/CT: a prospective proof-of-concept cohort study.

Zhu Zhaohui Z Yin Yufeng Y Zheng Kun K Li Fang F Chen Xiaoyuan X Zhang Fengchun F Zhang Xuan X

Annals of the rheumatic diseases 20140214 6

<h4>Background</h4>The study aimed to evaluate the use of positron emission tomography/computed tomography (PET/CT) with (68)Ga-PRGD2 as the tracer for imaging of synovial angiogenesis in patients with rheumatoid arthritis (RA).<h4>Methods</h4>Twenty untreated active patients with RA underwent (68)Ga-PRGD2 PET/CT and (18)F-FDG PET/CT before treatment; two patients with osteoarthritis served as controls. Among the 20 patients with RA, 12 repeated the evaluations after 3-month treatment. The image ...[more]

PMID: 24532680

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Project description:BackgroundFluorine-18-labeled SSAs have the potential to become the next-generation tracer in SSTR-imaging in neuroendocrine tumor (NET) patients given their logistical advantages over the current gold standard gallium-68-labeled SSAs. In particular, [18F]AlF-OC has already shown excellent clinical performance. We demonstrated in our previous report from our prospective multicenter trial that [18F]AlF-OC PET/CT outperforms [68Ga]Ga-DOTA-SSA, but histological confirmation was lacking due to ethical and practical reasons. In this second arm, we therefore aimed to provide evidence that the vast majority of [18F]AlF-OC PET lesions are in fact true NET lesions by analyzing their MR characteristics on simultaneously acquired MRI. We had a special interest in lesions solely detected by [18F]AlF-OC ("incremental lesions").MethodsTen patients with a histologically confirmed neuroendocrine tumor (NET) and a standard-of-care [68Ga]Ga-DOTATATE PET/CT, performed within 3 months, were prospectively included. Patients underwent a whole-body PET/MRI (TOF, 3 T, GE Signa), 2 hours after IV injection of 4 MBq/kg [18F]AlF-OC. Positive PET lesions were evaluated for a corresponding lesion on MRI. The diagnostic performance of both PET tracers was evaluated by determining the detection ratio (DR) for each scan and the differential detection ratio (DDR) per patient.ResultsIn total, 195 unique lesions were detected: 167 with [68Ga]Ga-DOTATATE and 193 with [18F]AlF-OC. The DR for [18F]AlF-OC was 99.1% versus 91.4% for [68Ga]Ga-DOTATATE, significant for non-inferiority testing (p = 0.0001). Out of these 193 [18F]AlF-OC lesions, 96.2% were confirmed by MRI to be NET lesions. Thirty-three incremental lesions were identified by [18F]AlF-OC, of which 91% were confirmed by MRI and considered true positives.ConclusionThe DR of [18F]AlF-OC was numerically higher and non-inferior to the DR of [68Ga]Ga-DOTATATE. [18F]AlF-OC lesions and especially incremental lesions were confirmed as true positives by MRI in more than 90% of lesions. Taken together, these data further validate [18F]AlF-OC as a new alternative for SSTR PET in clinical practice. Trial registration ClinicalTrials.gov: NCT04552847. Registered 17 September 2020, https://beta.Clinicaltrialsgov/study/NCT04552847.

Dataset Information

Evaluation of synovial angiogenesis in patients with rheumatoid arthritis using ??Ga-PRGD2 PET/CT: a prospective proof-of-concept cohort study.

Publications

Evaluation of synovial angiogenesis in patients with rheumatoid arthritis using ⁶⁸Ga-PRGD2 PET/CT: a prospective proof-of-concept cohort study.

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