Comparison of integrin alpha(v)beta(3) expression with Ga-68-NODAGA-RGD PET/CT and glucose metabolism with F-18-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 Ga-68-NODAGA-RGD PET/CT with that of F-18-FDG PET/CT regarding tumoral uptake and distribution, as well as histopathologic examination.Methods Ten Ga-68-NODAGA-RGD and ten F-18-FDG PET/CT were performed in nine prospectively included participants (1 woman; aged 58 +/- 8.4 y, range 40-69 y). Maximum SUV (SUVmax) and metabolic tumor volumes (MTV) were calculated. The Mann-Whitney U test and Spearman correlation analysis (rho) were used.Results Ga-68-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. F-18-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, SUVmax of F-18-FDG was significantly higher than those of Ga-68-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 SUVmax in an osseous metastasis with Ga-68-NODAGA-RGD as compared to F-18-FDG (6.6 vs. 3.9 g/mL). Correlation analysis showed positive correlation between F-18-FDG and Ga-68-NODAGA-RGD PET parameters (rho = 0.56, p = 0.012 for SUVmax, rho = 0.78, p < 0.001 for lesion-to-background ratios and rho = 0.58, p = 0.024 for MTV). We observed that F-18-FDG uptake was homogenous inside all the confirmed primary sites (n = 9). In contrast, Ga-68-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, Ga-68-NODAGA-RGD has lower potential in the detection of esophageal or esophagogastric junction malignancies compared to F-18-FDG. However, the results suggest that PET imaging of integrin alpha(v)beta(3) expression may provide complementary information and could aid in tumor diversity and delineation.