Comparison of integrin α(v)β(3) expression with (68)Ga-NODAGA-RGD PET/CT and glucose metabolism with (18)F-FDG PET/CT in esophageal or gastroesophageal junction cancers

BACKGROUND: The primary aims of this study were to compare in patients with esophageal or esophagogastric junction cancers the potential of (68)Ga-NODAGA-RGD PET/CT with that of (18)F-FDG PET/CT regarding tumoral uptake and distribution, as well as histopathologic examination. METHODS: Ten (68)Ga-NODAGA-RGD and ten (18)F-FDG PET/CT were performed in nine prospectively included participants (1 woman; aged 58 ± 8.4 y, range 40–69 y). Maximum SUV (SUV(max)) and metabolic tumor volumes (MTV) were calculated. The Mann–Whitney U test and Spearman correlation analysis (ρ) were used. RESULTS: (68)Ga-NODAGA-RGD PET/CT detected positive uptake in 10 primary sites (8 for primary tumors and 2 for local relapse suspicion), 6 lymph nodes and 3 skeletal sites. (18)F-FDG PET/CT detected positive uptake in the same sites but also in 16 additional lymph nodes and 1 adrenal gland. On a lesion-based analysis, SUV(max) of (18)F-FDG was significantly higher than those of (68)Ga-NODAGA-RGD (4.9 [3.7–11.3] vs. 3.2 [2.6–4.2] g/mL, p = 0.014). Only one participant showed a higher SUV(max) in an osseous metastasis with (68)Ga-NODAGA-RGD as compared to (18)F-FDG (6.6 vs. 3.9 g/mL). Correlation analysis showed positive correlation between (18)F-FDG and (68)Ga-NODAGA-RGD PET parameters (ρ = 0.56, p = 0.012 for SUV(max), ρ = 0.78, p < 0.001 for lesion-to-background ratios and ρ = 0.58, p = 0.024 for MTV). We observed that (18)F-FDG uptake was homogenous inside all the confirmed primary sites (n = 9). In contrast, (68)Ga-NODAGA-RGD PET showed more heterogenous uptake in 6 out of the 9 confirmed primary sites (67%), seen mostly in the periphery of the tumor in 5 out of the 9 confirmed primary sites (56%), and showed slight extensions into perilesional structures in 5 out of the 9 confirmed primary sites (56%). CONCLUSIONS: In conclusion, (68)Ga-NODAGA-RGD has lower potential in the detection of esophageal or esophagogastric junction malignancies compared to (18)F-FDG. However, the results suggest that PET imaging of integrin α(v)β(3) expression may provide complementary information and could aid in tumor diversity and delineation. Trial registration: Trial registration: NCT02666547. Registered January 28, 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02666547.