Objectives

This case report highlights the unexpected uptake of 68Ga-Trivehexin in non-malignant fibrotic lung tissue in a patient with recurrent lung adenocarcinoma.
It suggests that integrin-targeted PET imaging with 68Ga-Trivehexin may have potential in the assessment of fibrotic diseases, such as radiation-induced pulmonary fibrosis.

Methodology

The study utilized [18F]FDG PET/CT and 68Ga-Trivehexin PET/CT for imaging.
68Ga-Trivehexin is described as having high specificity for epithelial malignancies due to its targeting of the αvβ6 integrin receptor.
Bronchoalveolar lavage was used to rule out infection and malignancy.

The case involves a 55-year-old male with recurrent right lung adenocarcinoma.
Initial diagnosis was left upper lobe adenocarcinoma (cT2acN0cM0, stage IB).
Follow-up CT showed near-total reduction of the left lung tumor and mild post-radiation changes after chemoradiotherapy.
Both [18F]FDG PET/CT and 68Ga-Trivehexin PET/CT showed uptake in the recurrent lesion (blue arrows).
Fibrotic infiltrates (red arrows) in the left lung showed no [18F]FDG uptake but did show 68Ga-Trivehexin uptake.

This is a single case report, which limits the generalizability of the findings. Further studies with larger patient cohorts are needed to confirm these observations.
The report lacks quantitative data regarding the intensity of 68Ga-Trivehexin uptake in the fibrotic tissue compared to the malignant lesion. Providing standardized uptake values (SUV) would strengthen the report.
The mechanism of 68Ga-Trivehexin uptake in fibrotic tissue is discussed based on existing literature, but further investigation into the specific molecular pathways involved in this case would be beneficial.