摘要目的:探讨同时靶向生长抑素受体(SSTR)和整合素α vβ 3的新型双靶点分子探针 68Ga-1，4，7-三氮杂环壬烷-1，4，7-三乙酸-3聚乙二醇- D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽-精氨酸-甘氨酸-天冬氨酸(NOTA-3P-TATE-RGD)PET/CT显像用于神经内分泌肿瘤(NEN)的价值。 方法:前瞻性纳入2021年4月至2022年2月间北京协和医院的35例经病理证实的NEN患者[男19例、女16例，中位年龄54(41，61)岁]，所有患者在1周内行 68Ga-NOTA-3P-TATE-RGD和 68Ga-1，4，7，10-四氮杂环十二烷-1，4，7，10-四乙酸- D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽(DOTATATE) PET/CT显像。采用Wilcoxon符号秩检验比较2种显像检出的病灶数目、SUV max和肿瘤/本底比值(TBR)的差异。 结果:68Ga-NOTA-3P-TATE-RGD和 68Ga-DOTATATE PET/CT显像检出的病灶总数分别为1 190和1 106个，两者均检出35个原发肿瘤，对淋巴结转移灶[4(1，8)和4(1，8)个； z＝－0.45， P＝0.655]及骨转移灶[5(2，60)和5(2，66)个； z＝－1.11， P＝0.244]的检测能力相当，但 68Ga-NOTA-3P-TATE-RGD检出的肝转移灶数量明显多于 68Ga-DOTATATE[(17(6，27)和8(3，26)个； z＝－2.31， P＝0.021]。肿瘤的 68Ga-DOTATATE摄取程度明显高于 68Ga-NOTA-3P-TATE-RGD摄取[SUV max：15.6(9.9，24.9)和12.7(8.0, 18.4)； z＝－7.19， P<0.001]，但肝转移灶 68Ga-DOTATATE显像明显较 68Ga-NOTA-3P-TATE-RGD显像的TBR低[3.4(1.8，5.5)和6.1(3.8，10.8)； z＝－7.56， P<0.001]。 结论:68Ga-NOTA-3P-TATE-RGD对NEN肝转移灶的检出能力优于 68Ga-DOTATATE，而对于其他部位病灶的检出能力与 68Ga-DOTATATE相当。

abstractsObjective:To investigate the value of PET/CT imaging with 68Ga-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid-3 polyethylene glycol- D-Phe1-Tyr3-Thr8-octreotide Arg-Gly-Asp (NOTA-3P-TATE-RGD), a dual somatostatin receptor 2- and integrin α vβ 3- targeting tracer, in the evaluation of neuroendocrine neoplasms (NEN). Methods:From April 2021 to February 2022, 35 patients (19 males, 16 females; median age 54(41, 61) years) with histologically confirmed NEN in Peking Union Medical College Hospital were prospectively enrolled. All patients were scanned with both 68Ga-NOTA-3P-TATE-RGD and 68Ga-1, 4, 7, 1 0-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) PET/CT imaging within one week. The differences of the numbers of detected lesions, SUV max and tumor-to-background ratio (TBR) between the two imaging methods were compared by Wilcoxon signed-rank test. Results:Of the 35 patients, the total numbers of lesions detected by 68Ga-NOTA-3P-TATE-RGD and 68Ga-DOTATATE were 1 190 and 1 106, respectively. 68Ga-NOTA-3P-TATE-RGD and 68Ga-DOTATATE both detected 35 primary tumors and performed comparably in detecting lymph node metastases (4(1, 8) vs 4(1, 8); z=-0.45, P=0.655) and bone metastases (5(2, 60) vs 5(2, 66); z=-1.11, P=0.244). However, the number of liver lesions detected by 68Ga-NOTA-3P-TATE-RGD was significantly higher than that by 68Ga-DOTATATE (17(6, 27) vs 8(3, 26); z=-2.31, P=0.021). 68Ga-DOTATATE demonstrated higher SUV max than 68Ga-NOTA-3P-TATE-RGD (15.6(9.9, 24.9) vs 12.7(8.0, 18.4); z=-7.19, P<0.001), while the TBR of liver metastases was significantly lower (3.4(1.8, 5.5) vs 6.1(3.8, 10.8); z=-7.56, P<0.001). Conclusion:68Ga-NOTA-3P-TATE-RGD performs better than 68Ga-DOTATATE in the detection of liver metastases, while is comparable to 68Ga-DOTATATE in detecting lesions of other sites.