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Chimeric antigen receptor T-cell (CAR-T) therapy is an emerging cancer immunotherapy strategy in recent years. CAR-T therapy has shown significant efficacy in the treatment of relapsed or refractory diffuse large B cell lymphoma and refractory pediatric acute lymphoblastic leukemia. However, restricted by the complexity of solid tumor microenvironment, the application of CAR-T therapy in solid tumors is still underway. Molecular imaging can trace the in vivo status of T cells in real time and in depth, which is of great significance to investigate the biological behavior of CAR-T cells in vivo and to evaluate their activation status. Meanwhile, molecular imaging strategy can also act as an early predictor of CAR-T treatment efficacy and related side effects, which can provide effective information for clinical intervention and play an important role in guiding the development of CAR-T therapy.
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Objective To evaluate the value of 68 Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-1-Nal3-octreotide ( DOTANOC) PET/CT imaging in the diagnosis and staging of pancreatic neuroendocrine neoplasms ( pNENs) . Methods Data of 48 patients ( 18 males, 30 females, age: 23-86 (50.0±14.7) years) who underwent 68Ga-DOTANOC PET/CT imaging from June 2016 to June 2018 were retrospectively analyzed. The histopathological results were considered as the gold standard. The diagnostic efficacies of 68 Ga-DOTANOC PET/CT imaging and conventional imaging ( CI) for pNENs were analyzed and compared ( McNemar test) . Imaging characteristics of true positive lesions in 68 Ga-DOTANOC PET/CT ima-ging were analyzed. The maximum standardized uptake value ( SUVmax ) in different pathological grades of pNENs lesions were compared (Kruskal-Wallis rank sum test). Accuracy for TNM staging by 68Ga-DOTANOC PET/CT imaging and the correlations between the staging results and clinical TNM stages were analyzed (R× C contingency table). Results (1) The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 68Ga-DOTANOC PET/CT imaging were 93.8％(30/32), 14/16, 93.8％(30/32), 14/16 and 91.7％(44/48). All true positive lesions detected by PET/CT showed focal up-take of 68 Ga-DOTANOC with SUVmax of 30. 52 ± 23. 57. There were 26 patients with confirmed pathological grades of G1 (n=10;SUVmax:28.20 (17.60, 49.22)), G2 (n=13; SUVmax: 27.60 (13.05, 56.08)) and G3 (n=3;SUVmax:13.68(10.02, 27.80)), with no significant difference in SUVmax among 3 groups (H=0.495, P>0.05). (2)Of the 48 patients, 95.8％(46/48) also underwent CI concurrent with PET/CT. The sensitivity, specificity, PPV, NPV and accuracy of CI were 60.0％(18/30), 9/16, 72.0％(18/25), 9/21 and 58.7％(27/46). The diagnostic efficacy of 68Ga-DOTANOC PET/CT imaging was significantly higher than that of CI ( P=0.041) . ( 3) The accuracies of 68 Ga-DOTANOC PET/CT imaging for T, N, M staging were 93.3％(28/30), 6/6, 9/10, respectively, and the staging results were significantly correlated with clinical TNM stages (r=0.880, P<0.05). Conclusion 68Ga-DOTANOC PET/CT imaging has great values in the diagnosis and staging of pNENs.
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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.68GaNOTA-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) respectively in 68Ga-NOTA-NFB imaging and 18F-FDG imaging.The T/NT ratios for primary lesions were not significantly different between the two imaging methods (9.36±7.81 vs 15.62±14.51;t=-1.63,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.