探讨氨基酸转运和 PSMA 分子通路成像在转移性乳腺浸润性小叶癌 (ILC) 检测中的可行性，以及与标准护理成像 [计算机断层扫描 (CT)/骨扫描、或 18F-FDG 正电子发射断层扫描 (PET)-CT]。20 名患有新发或疑似转移性 ILC 的女性在不同的日子接受了两次 18F-氟昔洛韦和 68Ga-PSMA-11 PET-CT 扫描。将每位患者和每位患者 3 个区域（同侧腋窝淋巴结 (LN)、腋窝外 LN（同侧锁骨上或内乳）或远处疾病部位）的摄取量与标准护理成像（CT/骨扫描）进行比较13 名患者接受 18F-FDG PET-CT 治疗，7 名患者接受 18F-FDG PET-CT）。结果与综合事实标准相关。使用 McNemar 检验比较确认检出率 (cDR)。通过 t 检验比较每个真阳性转移区域最活跃病变和完整原发病变中 18F-氟昔洛芬和 68Ga-PSMA-11 的平均 SUVmax。标准护理成像的 cDR 为 5 例患者中的 5/20。 /60 个地区。 68Ga-PSMA-11 PET-CT 在 7/60 地区的 7/20 患者中检测到转移。 18F-氟西洛素 PET-CT 在 12/60 的地区检测到 9/20 名患者的转移。在患者和组合区域水平上，18F-氟西洛素 PET-CT 的 cDR 显着高于标准护理成像，而 68Ga-PSMA-11 和标准护理成像之间没有显着差异。 18F-氟昔洛韦 cDR 在组合区域水平上也显着高于 68Ga-PSMA-11。使用 18F-fluciclovine (n = 18) 治疗的真阳性转移性和原发性病变的平均 SUVmax 显着大于 68Ga-PSMA-11 (n = 11) [分别为 5.5 ± 1.8 与 3.5 ± 2.7，p = 0.021]。根据探索性试验，与标准护理成像和 68Ga-PSMA-11 相比，18F-氟昔洛韦 PET-CT 对 ILC 转移的 cDR 显着更高。 18F-fluciclovine 的真阳性恶性肿瘤的平均 SUVmax 显着高于 68Ga-PSMA-11。该试验的探索性数据表明 ILC 患者氨基酸代谢的分子成像值得进一步研究。由美国国立卫生研究院 (R21CA256280) 资助的早期 (I-II) 临床试验 (NCT04750473)。© 2024。作者( s)，获得 Springer-Verlag GmbH 德国（施普林格自然的一部分）的独家许可。

To explore the feasibility of imaging amino-acid transport and PSMA molecular pathways in the detection of metastatic breast invasive lobular carcinoma (ILC) and if there is superior detection compared to standard-of-care imaging [computed tomography (CT)/bone scan, or 18F-FDG positron-emission-tomography (PET)-CT].20 women with de-novo or suspected metastatic ILC underwent two PET-CT scans with 18F-fluciclovine and 68Ga-PSMA-11 on separate days. Uptake per patient and in 3 regions per patient - ipsilateral axillary lymph node (LN), extra-axillary LN (ipsilateral supraclavicular or internal mammary), or distant sites of disease - was compared to standard-of-care imaging (CT/bone scan in 13 patients and 18F-FDG PET-CT in 7 patients). Results were correlated to a composite standard of truth. Confirmed detection rate (cDR) was compared using McNemar's test. Mean SUVmax of 18F-fluciclovine and 68Ga-PSMA-11 in the most avid lesion for each true positive metastatic region and intact primary lesion were compared by t-test.The cDR for standard-of-care imaging was 5/20 patients in 5/60 regions. 68Ga-PSMA-11 PET-CT detected metastasis in 7/20 patients in 7/60 regions. 18F-fluciclovine PET-CT detected metastasis in 9/20 patients in 12/60 regions. The cDR for 18F-fluciclovine PET-CT was significantly higher versus standard-of-care imaging on the patient and combined region levels, while there were no significant differences between 68Ga-PSMA-11 and standard-of care imaging. 18F-fluciclovine cDR was also significantly higher than 68Ga-PSMA-11 on the combined region level. Mean SUVmax for true positive metastatic and primary lesions with 18F-fluciclovine (n = 18) was significantly greater than for 68Ga-PSMA-11 (n = 11) [5.5 ± 1.8 versus 3.5 ± 2.7 respectively, p = 0.021].In this exploratory trial, 18F-fluciclovine PET-CT has a significantly higher cDR for ILC metastases compared to standard-of-care imaging and to 68Ga-PSMA-11. Mean SUVmax for true positive malignancy was significantly higher with 18F-fluciclovine than for 68Ga-PSMA-11. Exploratory data from this trial suggests that molecular imaging of amino acid metabolism in patients with ILC deserves further study.Early phase (I-II) clinical trial (NCT04750473) funded by the National Institutes of Health (R21CA256280).© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.