Integrin αvβ6‐Targeted PET/CT Imaging of Non‐Small Cell Lung Cancer with [ <sup>68</sup> Ga]Ga‐Trivehexin: Improved Preoperative Lymph Node Staging and Association with Immunohistochemistry
Huiqin Wu, Chongjiao Li, Ling Li, Yueli Tian, Zhiwei Xiao, Yiwei Huang, Juan Zhong, Jianying Huang, Qiongrong Chen, Yong He
Abstract
Abstract Integrin αvβ6, an epithelial‐specific integrin, plays a crucial role in the development and prognosis of multiple tumors and has emerged as a potential target for cancer diagnosis and treatment. The novel integrin αvβ6‐targeted radiotracer [ 68 Ga]Ga‐Trivehexin shows excellent targeting specificity and favorable tumor‐to‐background contrast. In this prospective clinical study (NCT05835570) involving 58 participants with non‐small cell lung cancer (NSCLC), [ 68 Ga]Ga‐Trivehexin and 2‐deoxy‐2‐[ 18 F]fluoro‐ D ‐glucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) showed perfect diagnostic accuracy (100%, 58/58) for the detection of primary tumors. In detecting lymph node metastasis, [ 68 Ga]Ga‐Trivehexin exhibited similar diagnostic sensitivity to [ 18 F]FDG PET/CT (80.0% vs 72.0%), with higher specificity (93.8% vs 62.5%, p < 0.001) and accuracy (91.2% vs 64.2%, p < 0.001) in per‐station analysis. [ 68 Ga]Ga‐Trivehexin outperformed [ 18 F]FDG in detecting brain metastasis (sensitivity, 92.3% vs 38.5%; p = 0.031). Additionally, [ 68 Ga]Ga‐Trivehexin PET/CT results changed the therapeutic regimens of 14 (24.1%) participants. The maximum standardized uptake value (SUVmax) and tumor‐to‐liver parenchyma ratio (TLR) derived from [ 68 Ga]Ga‐Trivehexin correlated with integrin β6 expression in NSCLC. Overall, [ 68 Ga]Ga‐Trivehexin PET/CT represents an invaluable tool for identifying lymph node and brain metastases and shows comparable diagnostic efficacy in detecting primary tumors and other distant metastases compared with [ 18 F]FDG in NSCLC, potentially guiding treatment decision‐making.