Ren-cong Liu¹, Shao-hua Li¹, Guo-qiang Shao¹, Jun Wang¹, Le-le Zhang², Qing-le Meng¹, Feng Wang¹

¹Department of NuclearMedicine, Nanjing Hospital Affiliated to Nanjing Medical University.

²Department of NuclearMedicine, Nanjing Hospital Affiliated to Nanjing Medical University

Objective: The purpose of this study is toinvestigate the clinical value of ^99mTc-galacto-RGD2 SPECT/CTin the diagnosis of refractory thyroid carcinoma and correlate with integrinαvβ3 expression in the tumor. 

Method: 7 patients with poorlydifferentiated thyroid carcinoma, 5 patients with anaplastic thyroid carcinomaand 10 patients with refractory thyroid cancer which could not be completelyremoved by surgery were enrolled in this study from 2012 to 2015 were examinedwith ^99mTc-galacto-RGD₂ SPECT/CT. ROI analysis was usedto calculate tumor uptake which was expressed as the ratio of tumor to normaltissue in the contralateral (T/NT). Final diagnosis was confirmed byhistopathology, metastasis in the lymph node, lung and bone was confirmed inimaging follow-up, such as ultrasound, CT, bone scan and ¹³¹I whole-body scan. Tumor samples were collected in 10 patients, CD31 and integrin αvβ₃ expression was measured with immunochemistry assay.

Result: 88 lesions were totally found by ^99mTc-galacto-RGD2SPECT / CT in these 22 patients, 52/88 (59.10%) lymph nodes metastasis, 5/88(5.68%)diffuse pulmonary metastasis, 8/88(9.00%) bone metastasis including 3/8(37.5%)multiple bone metastasis. T/NT in the tumors was 6.78±1.23, significantlycorrelated with expression of integrin αvβ₃ in tumors (r=0.78, P<0.05).

Conclusion: ^99mTc-galacto-RGD2SPECT/CT was sensitive not only for the detection of the primary lesionsbut lymph node and bone, moreover, this imaging technique is a tumor positiveimaging, had more merits for the evaluation of T staging. Furthermore, ^99mTc-galacto-RGD₂SPECT/CT can be served as valuable tool for quantitation of integrin αvβ3expression. This study will shed light on integrin targeted therapy inrefractory thyroid carcinoma, further study is needed.

Key Words: Refractory thyroidcarcinoma, RGD SPECT/CT