Diagnostic performance of 68Ga-Trivehexin PET/CT and head-to-head comparison with 18F-FDG PET/CT in patients with triple negative breast cancer

: Background Triple-negative breast cancer (TNBC) is a highly aggressive tumor with poor prognosis at advanced stages. The tumor microenvironment (TME) in breast cancer plays a crucial role in tumor development and significantly influences disease progression. This prospective study explores the role of αvβ6 integrin receptor imaging ( 68 Ga-Trivehexin PET/CT) as a diagnostic and potential future therapeutic target in TNBC patients. Methods In this study, we evaluated the diagnostic performance of αvβ6 integrin receptor imaging using 68 Ga-Trivehexin PET/CT in TNBC patients and compared it head-to-head with 18 F-FDG PET/CT. Results The study included 21 patients (all female) with TNBC. There was comparable uptake of 68 Ga-Trivehexin and 18 F-FDG in primary, nodal and metastatic lesions. The sensitivity, specificity, negative predictive value and positive predictive value of 68 Ga-Trivehexin PET/CT for the detection of local disease are 91.7%, 100%, 90% and 100% respectively. The sensitivity, specificity, negative predictive value and positive predictive value of 68 Ga-Trivehexin PET/CT for detection of nodal disease are 70%, 100%, 78.6% and 100% respectively. The sensitivity, specificity, negative predictive value and positive predictive value of 68 Ga-Trivehexin PET/CT for detection of distant metastases are 88.9%, 100%, 92.3% and 100% respectively. Compared to 18 F-FDG PET/CT, the sensitivity and specificity of 68 Ga-Trivehexin for local and distant metastatic disease do not differ significantly; however, for nodal disease, the sensitivity of 68 Ga-Trivehexin is slightly lower than 18 F-FDG PET/CT. The agreement (kappa) for both primary and metastases detection imaging modalities were 0.8 and 0.9, respectively. However, 68 Ga-Trivehexin PET/CT showed overall lower SUVmax than 18 F-FDG PET/CT. Conclusions This study provides pertinent insights regarding the αvβ6 integrin receptor expression in patients with TNBC. This study also opened a new horizon in the therapeutic role of αvβ6 integrin receptor-labelled radionuclide for this aggressive breast cancer subtype.