Thoracic Cancer (Sep 2024)

Prospective study of 99mTc‐3PRGD2 SPECT/CT diagnosing metastatic lymph nodes in esophageal squamous cell carcinoma

  • Xiaojin Wang,
  • Guichao Liu,
  • Zhanyu Li,
  • Jiyun Shi,
  • Mingzhu Liang,
  • Guining Fu,
  • Liangzhan Lv,
  • Shaolong Ju,
  • Yin Wang,
  • Wenhua Xu,
  • Fan Wang,
  • Qingdong Cao,
  • Hong Shan

DOI
https://doi.org/10.1111/1759-7714.15421
Journal volume & issue
Vol. 15, no. 27
pp. 1958 – 1967

Abstract

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Abstract Background Lymph node (LN) metastasis is a significant prognostic factor for esophageal squamous cell carcinoma (ESCC), and there are no satisfactory methods for accurately predicting metastatic LNs. The present study aimed to assess the efficacy of 99mTc‐3PRGD2 single‐photon emission computed tomography (SPECT)/computed tomography (CT) for diagnosing metastatic LNs in ESCC. Methods A total of 15 enrolled patients with ESCC underwent 99mTc‐3PRGD2 SPECT/CT and 18F‐fluorodeoxyglucose positron emission tomography‐computed tomography (18F‐FDG PET/CT) examinations preoperatively. High‐definition bone carving reconstruction technology (HD‐xSPECT Bone) was applied to quantitatively assess the LN's SUVmax via SPECT/CT. The two methods were compared for diagnosing metastatic LNs with pathology as the gold standard. Results Among 15 patients, 23 metastatic lymph node stations (mLNSs) were predicted by SPECT/CT, with a mean SUVmax of 2.71 ± 1.34, of which 15 were pathologically confirmed; 32 mLNSs were predicted by PET/CT with a mean SUVmax of 4.41 ± 4.02, of which 17 were pathologically confirmed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SPECT/CT for diagnosing metastatic LNs were 62.50%, 91.30%, 85.34%, 65.22%, and 90.32%, respectively, and those of PET/CT were 70.83%, 83.70%, 81.03%, 53.13%, and 91.67%, respectively. There was no significant difference in sensitivity (p = 0.061) or specificity (p = 0.058) between the two methods. The AUCSPECT/CT was 0.816 and the SUVmax threshold was 2.5. Conclusion 99mTc‐3PRGD2 SPECT/CT might be an effective method for diagnosing metastatic LNs in ESCC, especially in combination with HD‐xSPECT Bone. The diagnostic efficiency of this method was noninferior to that of 18F‐FDG PET/CT. The SUVmax threshold of 2.5 showed the highest agreement with the pathology findings.

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