Paper
[68Ga]Ga-LNC1007 versus 2-[18F]FDG in the evaluation of patients with metastatic differentiated thyroid cancer: a head-to-head comparative study.
Published Oct 15, 2024 · Yun Chen, Shan Zheng, Jie Zang
European journal of nuclear medicine and molecular imaging
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Abstract
PurposeThis head-to-head comparison study aimed to compare the performance of [^68Ga]Ga-FAPI-RGD (LNC1007) and 2-[^18F]FDG PET/CT in the evaluation of patients with metastatic differentiated thyroid cancer (mDTC).MethodsTen unexplained hyperthyroglobulinemia (UHTg) patients and 20 patients with definite metastatic lesions of thyroid cancer (DmDTC) were enrolled in the study. All patients underwent both [^68Ga]Ga-LNC1007 and 2-[^18F]FDG PET/CT within 1 week. The final diagnosis was based on histopathological results and a comprehensive evaluation of laboratory tests and multimodal imaging characteristics.ResultsIn patients with UHTg, [^68Ga]Ga-LNC1007 PET/CT detected more metastatic lymph nodes (LNs) (17 vs. 15, P = 0.317) and lung lesions (2 vs. 0) than 2-[^18F]FDG. In patients with DmDTC, [^68Ga]Ga-LNC1007 PET/CT also detected more true positive lesions than 2-[^18F]FDG (Total: 133 vs. 103, LN: 20 vs. 15, lung: 18 vs. 10, bone: 87 vs.73). [^68Ga]Ga-LNC1007 PET/CT demonstrated significantly higher SUVmax (Total: 6.30 vs. 3.84, LN: 8.28 vs. 4.82, Lung: 3.31 vs. 1.49, Bone: 5.73 vs. 3.87, all P < 0.05) and TBR (Total: 6.92 vs. 4.93, LN: 6.48 vs. 4.16, Lung: 5.16 vs. 2.57, Bone: 7.22 vs. 5.41, all P < 0.05) in true positive lesions compared to 2-[^18F]FDG. Specifically, the sensitivity of [^68Ga]Ga-LNC1007 PET/CT was higher than that of 2-[^18F]FDG in detecting lung and bone metastases (94.7% vs. 52.6% and 100% vs. 83.9%, all P < 0.05). [^68Ga]Ga-LNC1007 PET/CT exhibited better specificity and accuracy in diagnosing LNs (96.9% vs. 66.7% and 96.3% vs. 68.5%, all P < 0.05). However, the specificity of [^68Ga]Ga-LNC1007 for bone metastasis was inferior to 2-[^18F]FDG (15.4% vs. 88.5%, P < 0.05).ConclusionCompared with 2-[^18F]FDG, [^68Ga]Ga-LNC1007 PET/CT could detect more metastatic lesions, with higher SUVmax and TBR, in patients with mDTC. [^68Ga]Ga-LNC1007 had better accuracy in the diagnosis of LN and lung metastasis.Trial registration ClinicalTrials.gov NCT05515783. Registered 01 May 2022.URL of registry https://classic.clinicaltrials.gov/ct2/show/NCT05515783
[68Ga]Ga-LNC1007 PET/CT detects more metastatic lesions and is more accurate in diagnosing lymph nodes and lung metastases than 2-[18F]FDG in patients with metastatic differentiated thyroid cancer.
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