Detectability of Al 18 F-NOTA-HER2-BCH PET for Nodal Metastases in Patients With HER2-Positive Breast Cancer

Xiaoyi Guo ¹, Jiayue Liu ¹, Shiyu Lin ²

⁰Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine; Peking University Cancer Hospital and Institute, Beijing, China.

Clinical Nuclear Medicine +

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January 24, 2025

View abstract on PubMed

Summary

Al 18F-NOTA-HER2-BCH PET/CT shows superior detection of nodal metastases in HER2-positive breast cancer compared to 18F-FDG PET/CT. This novel agent is particularly effective for identifying smaller lesions, improving diagnostic accuracy.

Area Of Science

Oncology
Nuclear Medicine
Radiochemistry

Background

HER2-positive breast cancer necessitates accurate staging for effective treatment.
Detecting nodal metastases is crucial for treatment planning and prognosis.
18F-FDG PET/CT is a standard imaging modality, but its sensitivity for nodal metastases can be limited.

Purpose Of The Study

To compare the diagnostic performance of Al 18F-NOTA-HER2-BCH PET/CT and 18F-FDG PET/CT in identifying nodal metastases in patients with HER2-positive breast cancer.
To evaluate the efficacy of Al 18F-NOTA-HER2-BCH for detecting both regional and nonregional lymph node involvement.

Main Methods

Retrospective analysis of 62 patients with pathologically confirmed HER2-positive breast cancer.
All participants underwent both Al 18F-NOTA-HER2-BCH and 18F-FDG PET/CT.
Visual assessment of tracer uptake and quantitative analysis (SUVmax, TBR) were performed. Diagnostic accuracy was assessed using c-statistics.

Main Results

Al 18F-NOTA-HER2-BCH demonstrated higher sensitivity (0.97) and specificity (0.97) compared to 18F-FDG (0.85, 0.77) for detecting nodal metastases on a per-patient basis.
Al 18F-NOTA-HER2-BCH detected significantly more axillary, extra-axillary, and nonregional lymph node metastases.
The agent was more effective in identifying smaller lesions (<10 mm) and showed higher SUVmax and TBR values, indicating greater tracer uptake in metastatic nodes.

Conclusions

Al 18F-NOTA-HER2-BCH PET/CT is more effective than 18F-FDG PET/CT for detecting nodal metastases in HER2-positive breast cancer.
The improved detection is especially notable for smaller lymph node metastases.
Al 18F-NOTA-HER2-BCH represents a promising advancement in the molecular imaging of HER2-positive breast cancer staging.

Keywords:

PET/CT breast cancer lymph node metastases

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