Purpose: 68Ga-Trivehexin is a PET tracer targeting αvβ6-integrin, a
transmembrane receptor that is frequently expressed by pancreatic cancer
cells. This study aimed to determine the biokinetics, image contrast, and
acquisition parameters for 68Ga-Trivehexin PET imaging in pancreatic cancers.
Methods: 44 patients with pancreatic cancer underwent Trivehexin PET/CT
between June 2021 and November 2022 (EK-242052023). Biokinetics and
-distribution were extracted. Previous imaging follow-up imaging, and
histological findings were used as reference standards. A one-way ANOVA test,
followed by Tukey HSD post-hoc test was conducted. T-tests for subgroups ±
chemotherapy prior to PET were performed. Based on dynamic PET data
(n= 11) recorded over 45 min, time-activity curves were generated.
Results: 68Ga-Trivehexin PET/CT detected 40 pancreatic cancers, SUVmax 12.6;
range [5.1–30.8]; 39 liver metastases, SUVmax 7.9 [2.7–16.3]; 21 lymph node
metastases, SUVmax 8.6 [2.5–15.0]; 17 peritoneal metastases, SUVmax 9.5
[4.0–16.9] and 14 other metastases, SUVmax 7.2 [2.9–13.1]. Tukey post-hoc
analysis revealed significant differences for SUVmax in pancreatic cancer
compared to SUVmax in liver metastases [4.74, 95%-CI (1.74, 7.75)], for
SUVmax in pancreatic cancer to SUVmax in lymph node metastasis [4.07,
95%-CI (0.47, 7. 67)], for tumor-to-liver ratio (TLR) of liver metastasis to TLR of
pancreatic cancer [1.82, 95%-CI (0.83, 2.80)], for TLR of pancreatic cancer to
TLR of peritoneal carcinomatoses [−1.88, 95%-CI (−3.15, −0.61)], and TLR of
pancreatic cancer to TLR of pleural carcinomatosis [−2.79, 95%-CI (−5.42,
−0.18)]. When comparing subgroups ± chemotherapy prior to PET, TLR of
pancreatic cancers and TLR of peritoneal carcinomatoses were significantly
different. At 45 min p.i., the highest tumor-to-backround (TBR) was observed.
Conclusion: 68Ga-Trivehexin is suitable for imaging of αvβ6-integrin expression
in pancreatic cancer due to its ability to distinguish primary carcinoma and
metastases from background tissue.