Arteriovenous malformations (AVMs) have an inherent capacity to form new blood vessels, resulting in excessive lesion growth, and this process is further triggered by the release of angiogenic factors. ⁶⁸Ga-labeled arginine-glycine-aspartate tripeptide sequence (RGD) PET/CT imaging may provide insight into the angiogenic status and treatment response of AVMs. This clinical feasibility study was performed to demonstrate that ⁶⁸Ga-RGD PET/CT imaging can be used to quantitatively assess angiogenesis in peripheral AVMs. Methods: Ten patients with a peripheral AVM (mean age, 40 y; 4 men and 6 women) and scheduled for endovascular embolization treatment were prospectively included. All patients underwent ⁶⁸Ga-RGD PET/CT imaging 60 min after injection (mean dose, 207 ± 5 MBq). Uptake in the AVM, blood pool, and muscle was quantified as SUV_max and SUV_peak, and a descriptive analysis of the PET/CT images was performed. Furthermore, immunohistochemical analysis was performed on surgical biopsy sections of peripheral AVMs to investigate the expression pattern of integrin α_vβ₃. Results: ⁶⁸Ga-RGD PET/CT imaging showed enhanced uptake in all AVM lesions (mean SUV_max, 3.0 ± 1.1; mean SUV_peak, 2.2 ± 0.9). Lesion-to-blood and lesion-to-muscle ratios were 3.5 ± 2.2 and 4.6 ± 2.8, respectively. Uptake in blood and muscle was significantly higher in AVMs than in background tissue (P = 0.0006 and P = 0.0014, respectively). Initial observations included uptake in multifocal AVM lesions and enhanced uptake in intraosseous components in those AVM cases affecting bone integrity. Immunohistochemical analysis revealed cytoplasmatic and membranous integrin α_vβ₃ expression in the endothelial cells of AVMs. Conclusion: This feasibility study showed increased uptake in AVMs with angiogenic activity, compared with surrounding tissue without angiogenic activity, suggesting that ⁶⁸Ga-RGD PET/CT imaging can be used as a tool to quantitatively determine angiogenesis in AVMs. Further studies will be conducted to explore the potential of ⁶⁸Ga-RGD PET/CT imaging for guiding current treatment decisions and for assessing response to antiangiogenic treatment.

动静脉畸形（AVM）具有形成新血管的固有能力，从而导致过度的病灶生长，并且此过程进一步由血管生成因子的释放触发。⁶⁸ Ga标记的精氨酸-甘氨酸-天冬氨酸三肽序列（RGD）PET / CT成像可洞察AVM的血管生成状态和治疗反应。进行该临床可行性研究以证明⁶⁸ Ga-RGD PET / CT成像可用于定量评估外周AVM中的血管生成。方法：前瞻性纳入10例周围性AVM（平均年龄40岁；男4例，女6例）并计划行血管内栓塞治疗的患者。所有患者均接受了⁶⁸注射后60分钟进行Ga-RGD PET / CT成像（平均剂量207±5 MBq）。AVM，血池和肌肉的摄取被量化为SUV _max和SUV_峰值，并对PET / CT图像进行描述性分析。此外，在外围动静脉畸形手术活检切片进行免疫组织化学分析，以研究的整合素α的表达模式_v β ₃。结果： ⁶⁸ Ga-RGD PET / CT成像显示所有AVM病变的摄取均增加（平均SUV _max，3.0±1.1；平均SUV_峰值，2.2±0.9）。病变与血液的比例和病变与肌肉的比例分别为3.5±2.2和4.6±2.8。AVM中血液和肌肉的摄取显着高于背景组织（分别为P = 0.0006和P = 0.0014）。最初的观察结果包括在多灶性AVM病变中摄取并在影响骨骼完整性的那些AVM病例中增加了骨内成分的摄取。免疫组织化学分析揭示了胞质和膜整合素α _v β ₃在动静脉畸形的内皮细胞中的表达。结论：该可行性研究表明，与无血管生成活性的周围组织相比，具有血管生成活性的AVM的摄取增加，表明⁶⁸Ga-RGD PET / CT成像可用作定量确定AVM中血管生成的工具。将进行进一步的研究，以探索⁶⁸ Ga-RGD PET / CT成像在指导当前治疗决策和评估对抗血管生成治疗的反应方面的潜力。