Noninferiority of 99mTc-Ethylenedicysteine-Glucosamine as an Alternative Analogue to 18F-Fluorodeoxyglucose in the Detection and Staging of Non-Small Cell Lung Cancer

الملخص EN

Objective.

99 m Tc-ethylenedicysteine-glucosamine ( 99 m Tc-EC-G) was developed as a potential alternative to 18F-FDG for cancer imaging.

A Phase 2 study was conducted to compare 18F-FDG PET/CT and 99 m Tc-EC-G SPECT/CT in the detection and staging of patients with non-small cell lung cancer (NSCLC).

This study was aimed to demonstrate that 99 m Tc-EC-G SPECT/CT was not inferior to 18F-FDG PET/CT in patients with confirmed NSCLC.

Methods.

Seventeen patients with biopsy proven NSCLC were imaged with 99 m Tc-EC-G and 18F-FDG to detect and stage their cancers.

Imaging with PET/CT began 45–60 minutes after injection of 18F-FDG.

Imaging with 99 m Tc-EC-G began at two hours after injection (for 5 patients) or three hours (for 12 patients).

SPECT/CT imaging devices from the three major vendors of SPECT/CT systems were used at 6 participating study sites.

The image sets were blinded to all clinical information and interpreted by independent PET and SPECT expert readers at a central independent core laboratory.

Results.

100% concordance between 99 m Tc-EC-G and 18F-FDG for primary lesion detection, lesion location and size, and confidence that the biopsied lesion was malignant.

There was 70% agreement between 99 m Tc-EC-G and 18F-FDG for metastatic lesion detection, location and size, and confidence that the suspicious lesions were malignant.

Conclusions.

Evaluation of primary and suspicious metastatic lesions detected by 99 m Tc-EC-G and 18F-FDG on 17 patients resulted in excellent agreement for detection of primary and metastatic lesions.

The study results indicated that 99 m Tc-EC-G SPECT/CT has the potential to be a clinically viable alternative to 18F-FDG PET/CT and 99 m Tc-EC-G is not inferior to 18F-FDG PET/CT.