Cancer is currently the leading cause of death worldwide, with a global estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths recorded in 2020 (1). Early detection, diagnosis, and treatment are key measures for reducing mortality attributed to malignant tumors and prolonging survival time. The integrin alpha(α)v beta(β)3 receptor is frequently involved in the occurrence and development of malignant tumors (2, 3); it mediates cell–cell and cell–extracellular matrix adhesion (4, 5) and is related to tumor angiogenesis and metastasis (3, 6 – 8). The integrin αvβ3 receptor is highly expressed in activated endothelial cells and proliferating tumor cells; however, it is either not expressed or expressed at very low levels in normal endothelial cells, dormant vascular cells, and other normal cells (3, 9) and has a certain level of specificity. Therefore, the integrin αvβ3 receptor is a valuable target for diagnosing and treating malignant tumors.
Polypeptides containing the arginine-glycine-aspartate (Arg-Gly-Asp [RGD]) sequence can bind specifically to the integrin αvβ3 receptor with high selectivity and strong affinity (10). Hence, these polypeptides can specifically demarcate lesions and their angiogenesis for tumor detection and have promising prospects for tumor diagnosis and treatment. Radiolabeled RGD peptides and their analogs have been intensively studied for their application in the non-invasive imaging of integrin αvβ3 receptor expression (11 – 13).
The technetium-99m hydrazinonicotinamide-dimeric cyclic RGD peptide with three polyethylene glycol spacers (99m Tc-3PRGD2) is a 99m Tc-labeled molecular probe used in nuclear medicine for single-photon emission computed tomography (SPECT). Its core ligand, hydrazinonicotinamide-3PRGD2, is a new type of RGD dimer that can bind specifically to the integrin αvβ3 receptor with high selectivity and affinity. In addition, 99m Tc-3PRGD2 has rapid blood clearance and a high level of safety with no adverse reactions having been observed in animal models and humans to date (14, 15). 99m Tc-3PRGD2 SPECT imaging is widely used in clinical research because of its high diagnostic performance and excellent cost-effectiveness, which further highlight its potential for clinical applications. Herein, we review the advances in clinical research on 99m Tc-3PRGD2 SPECT imaging for tumor lesions over the past decade.








