Cancer Integrin Imaging with [68Ga]Ga-Trivehexin PET/CT for a Patient with Breast Cancer and Neuroendocrine Neoplasm: A Case of Both (18F)FDG PET/CT and [68Ga]Ga-DOTATATE Positive but Integrin avβ6 Negative Lesion on [68Ga]Ga-Trivehexin PET

Integrins play crucial roles in the migration of tumor cells during angiogenesis and metastasis. Consequently, αvβ6-integrin-targeted positron emission tomography (PET) radiopharmaceuticals have been developed and tested in humans, with clinical trials highlighting their applications in idiopathic pulmonary fibrosis and carcinomas. However, data on integrins are limited, and the role of [⁶⁸Ga]Ga-Trivehexin tomography/computed tomography (CT) PET/CT is not well-established. Some studies have suggested that [⁶⁸Ga]Ga-Trivehexin PET/CT is more specific than ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT, which can yield false-positive results. It has been shown to be more efficient in evaluating pancreatic lesions and head and neck tumors. The role of [⁶⁸Ga]Ga Trivehexin PET/CT in neuroendocrine tumors is not yet clearly defined. In our case, integrin was negative in the pancreatic neuroendocrine tumor but positive in the breast lobular tumor. Additionally, we observed that the lobular carcinoma lesion in the right breast is somatostatin receptor+positive on [⁶⁸Ga]Ga-DOTATATE PET/CT.