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Eur J Nucl Med Mol Imaging
Eur J Nucl Med Mol Imaging
European Journal of Nuclear Medicine and Molecular Imaging
1619-7070
1619-7089
Springer Berlin Heidelberg Berlin/Heidelberg

38771514
6750
10.1007/s00259-024-06750-6
Image of the Month
Concomitant metastatic head-and-neck cancer and pancreatic cancer assessed by αvβ6-integrin PET/CT using 68Ga-Trivehexin: incidental detection of a brain metastasis
http://orcid.org/0009-0002-2960-1996
Rehm Jana j.rehm@nuklearmedizindresden.de

1
Winzer Robert 1
Notni Johannes 2
Hempel Sebastian 3
Distler Marius 3
Folprecht Gunnar 4
Kotzerke Jörg 1
1 grid.4488.0 0000 0001 2111 7257 Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
2 TRIMT GmbH, Radeberg, Germany
3 grid.4488.0 0000 0001 2111 7257 Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
4 grid.4488.0 0000 0001 2111 7257 Medical Clinic I, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
21 5 2024
21 5 2024
2024
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8 3 2024
1 5 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Technische Universität Dresden (1019)Open Access funding enabled and organized by Projekt DEAL.

issue-copyright-statement© Springer-Verlag GmbH Germany, part of Springer Nature 2024
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pmc68Ga-Trivehexin is an investigative PET radiopharmaceutical targeting the “cancer integrin” αvβ6, a tumor cell biomarker which is highly expressed by various carcinomas [1]. Feasibility of targeting αvβ6-integrin for cancer imaging has been demonstrated in preclinical and first clinical applications [2, 3, 4, 5], warranting a clinical study of 68Ga-Trivehexin (NCT05799274).

The image shows a 68Ga-Trivehexin PET/CT (146 MBq, 60 min p.i. static scan, 5 bed positions) of a male patient (50 y, 69 kg), acquired as part of primary staging before therapy planning of a histologically confirmed pancreatic ductal adenocarcinoma (PDAC) in the pancreatic corpus. Furthermore, a tonsillar carcinoma, metastasized to the right cervical side with subsequent surgical resection and chemo-radiotherapy, was known. The lateral MIP (scaled to SUV 12) and corresponding coronal fusion (A) showed intense uptakes in the cerebellopontine angle (1, SUVmax 18.5) corresponding to a brain metastasis; in a supraclavicular metastasis (2, SUVmax 12.7); in the pancreatic corpus (3, SUVmax 17.0); and in retrocrural and retroperitoneal PDAC metastases (4, SUVmax 13.3). B, C, and D show coronal and transversal PET slices and fusion, respectively, of the cerebellopontine metastasis, which was subsequently confirmed by MRI (not shown). Left tumor exstirpation yielded a specimen for histological classification of the brain metastasis as squamous cell carcinoma (SCC) with basaloid growth, p40 and p63 positive. Cranial and supraclavicular metastases were thus assigned to tonsillar carcinoma without association to HPV according to immunohistochemistry. Altogether, 68Ga-Trivehexin PET/CT revealed two αvβ6-integrin expressing tumors, PDAC and SCC, and furthermore a metastasis of the latter in the brain, which is obviously not easily possible with [18F]FDG.

Authors’ contributions

Conceived and designed the experiment: Jana Rehm, Johannes Notni, Jörg Kotzerke. Performed the experiments: Jana Rehm, Robert Winzer. Analyzed the data: Robert Winzer, Jana Rehm. Wrote the original manuscript: Jana Rehm. All authors approved the final version of the manuscript.

Funding

This project received no external funding.

Open Access funding enabled and organized by Projekt DEAL.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval

The data analysis received approval from the responsible local ethics committees (EK-242052023).

Consent to participate

The authors affirm that the patient provided written informed consent prior to the investigation.

Consent for publication

The authors affirm that the patient provided written informed consent for publication of the images.

Competing interests

Johannes Notni: co-inventor of patents related to 68Ga-Trivehexin; co-founder, shareholder, and CSO of TRIMT GmbH (Radeberg, Germany); member of the scientific advisory board of Radiopharm Theranostics LLC (Carlton, Australia). All other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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