Head and neck tumors angiogenesis imaging with (68)Ga-NODAGA-RGD in comparison to (18)F-FDG PET/CT: a pilot study

BACKGROUND: Angiogenesis plays an important role in head and neck squamous cell carcinoma (HNSCC) progression. This pilot study was designed to compare the distribution of (68)Ga-NODAGA-RGD PET/CT for imaging α(v)β(3) integrins involved in tumor angiogenesis to (18)F-FDG PET/CT in patients with HNSCC. MATERIAL AND METHODS: Ten patients (aged 58.4 ± 8.3 years [range, 44–73 years], 6 males, 4 females) with a total of 11 HNSCC were prospectively enrolled. Activity mapping and standard uptake values (SUV) from both (68)Ga-NODAGA-RGD and (18)F-FDG PET/CT scans were recorded for primary tumor and compared with the Wilcoxon signed-rank test. The relation between the SUV of both tracers was assessed using the Spearman correlation. RESULTS: All HNSCC tumors were visible with both tracers. Quantitative analysis showed higher (18)F-FDG SUV(max) in comparison to (68)Ga-NODAGA-RGD (14.0 ± 6.1 versus 3.9 ± 1.1 g/mL, p = 0.0017) and SUV(mean) (8.2 ± 3.1 versus 2.0 ± 0.8 g/mL, p = 0.0017). Both (18)F-FDG and (68)Ga-NODAGA-RGD uptakes were neither correlated with grade, HPV status nor p16 protein expression (p ≥ 0.17). CONCLUSION: All HNSCC tumors were detected with both tracers with higher uptake with (18)F-FDG, however. (68)Ga-NODAGA-RGD has a different spatial distribution than (18)F-FDG bringing different tumor information. TRIAL REGISTRATION: NCT, NCT02666547. Registered 12.8.2012.