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Evaluation of bone-seeking novel radiotracer 68Ga-NO2AP-Bisphosphonate for the detection of skeletal metastases in carcinoma breast

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The successful labelling of bisphosphonates (BP) with 68Ga using macrocyclic chelators such as the based triazacyclononane (NO2AP) is a step forward in the in-house availability of a novel bone-seeking PET radiopharmaceutical with dual advantage of PET/CT imaging and generator production. In this study, we compared the novel generator-based skeletal radiotracer 68Ga-1,4,7-triazacyclonone-1,4-diacetic acid (68Ga-NO2AP-BP) with sodium fluoride (18F-NaF) for the detection of skeletal metastases in breast cancer patients. In addition, dosimetric analysis of 68Ga-NO2AP-BP was performed in a subset of patients.

Methods

This was a prospective study of histopathologically proven cases of breast cancer patients who were referred for bone scintigraphy and underwent positron emission tomography/computed tomography (PET/CT) with 18F-NaF and 68Ga-NO2AP-BP within a week in random order. The scans of each patient were compared both qualitatively for image quality and quantitatively for number of lesions and SUVmax of lesions. Dosimetric analysis was performed in five patients. Their PET/CT scans were acquired at multiple time points and urine and blood samples were collected. Dosimetric calculations were performed using OLINDA/EXM 1.1 software. Statistical analysis was done using Stata 13 (StataCorp) software package. An agreement analysis regarding number of lesions detected with the two skeletal radiotracers was carried out.

Results

The image quality of 68Ga-NO2AP-BP PET/CT scans were comparable to that of 18F-NaF. There was no statistically significant difference in the SUVmax of lesions, normal bone and lesion to background ratio between the two skeletal radiotracers. There was good agreement in the number of lesions detected by both skeletal radiotracers. The mean whole body effective dose for 68Ga-NO2AP-BP was 0.00583 mSv/MBq and the effective dose equivalent was 0.0086 mSv/MBq.

Conclusion

The excellent lesion detection agreement between 68Ga-NO2AP-BP and 18F-NaF favours the former as an alternative for skeletal scintigraphy in centres without an on-site cyclotron. The favourable dosimetric results and its potential to be used as a theranostic agent makes it an important generator-based skeletal radiotracer.

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Acknowledgement

We are grateful to Dr. Chandan J Das for his expertise in reporting the MRI brain scans and Dr. Ganesh Kumar M for keenly reviewing the manuscript. We acknowledge support from Prof. P. Hermann and Dr. V. Kubíček, Charles University in Prague, Czech Republic, for the preparation of NO2AP-BP.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Averilicia Passah, Madhavi Tripathi, Sanjana Ballal, Madhav Prasad Yadav, Rajeev Kumar, Partha Sarathi Chakraborty & Chandrasekhar Bal

  2. Nuclear Chemistry, Johannes-Gutenberg-University, Mainz, Germany

    Frank Roesch & Marian Meckel

Authors
  1. Averilicia Passah
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  2. Madhavi Tripathi
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  3. Sanjana Ballal
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  4. Madhav Prasad Yadav
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  5. Rajeev Kumar
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  6. Frank Roesch
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  7. Marian Meckel
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  8. Partha Sarathi Chakraborty
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  9. Chandrasekhar Bal
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Correspondence to Chandrasekhar Bal.

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The authors declare that they have no conflict of interest.

Ethical clearance

Ethical clearance received Ref. No. IESC/T-236/15.06.2013

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Informed consent was obtained from all patients.

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Passah, A., Tripathi, M., Ballal, S. et al. Evaluation of bone-seeking novel radiotracer 68Ga-NO2AP-Bisphosphonate for the detection of skeletal metastases in carcinoma breast. Eur J Nucl Med Mol Imaging 44, 41–49 (2017). https://doi.org/10.1007/s00259-016-3469-3

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  • DOI: https://doi.org/10.1007/s00259-016-3469-3

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