Initial clinical experience using ⁶⁸Ga-FAPI-46 PET/CT for detecting various cancer types.

IF 0.9 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Hellenic journal of nuclear medicine Pub Date : 2024-05-01 Epub Date: 2024-08-06 DOI:10.1967/s002449912723

Habibollah Dadgar, Nasim Norouzbeigi, Majid Assadi, Batool Al-Balooshi, Akram Al-Ibraheem, Abdulredha A Esmail, Fahad Marafi, Mohamad Haidar, Haider Muhsin Al-Alawi, Yehia Omar, Sharjeel Usmani, Andrea Cimini, Hossein Arabi, Habib Zaidi

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引用次数: 0

Abstract

Objective: Numerous studies have shown that gallium-68-labeled fibroblast activation protein inhibitor (⁶⁸Ga-FAPI) positron emission tomography/computed tomography (PET/CT) scans would yield high intra-tumoral tracer uptake and low uptake in normal tissues as background, thus allowing for excellent visualization of lesions in the cancer microenvironment. This study set out to compare the suitability of novel ⁶⁸Ga-FAPI-46 PET versus routine fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) PET and other few cases of ⁶⁸Ga-DOTATATE/⁶⁸Ga-Pentixafor PET/CT for the assessment of different types of cancer.

Subjects and methods: A retrospective analysis of 11 patients (6 males, 5 females; average age: 53 years, range: 10-58 years) with histopathologically confirmed, well-differentiated adenocarcinoma, medullar thyroid cancer (MTC), papillary thyroid carcinoma (PTC), cervical, gastric, glioblastoma multiform (GBM), colon, Ewing's sarcoma, and breast cancer was performed. These patients underwent PET/CT scans using four different radiotracers (9 ¹⁸F-FDG, 11 ⁶⁸Ga- FAPI, 3 ⁶⁸Ga-DOTATATE, and 1 ⁶⁸Ga-Pentixafor). The patients' PET/CT images were visually evaluated for cancer detection, and analyzed semi-quantitatively through image- derived metrics, such as target-to-background ratio (TBR) and maximum standardized uptake value (SUVmax), for recurrence and metastasis.

Results: The study of 11 patients revealed that ⁶⁸Ga-FAPI-46 was more effective than other tracers for detecting metastases, with 55 vs. 49 metastases in the lymph nodes, 4 vs. 3 in the liver, and 4 vs. 3 in the bones detected in comparison to ¹⁸F-FDG. No significant differences were observed in ⁶⁸Ga-DOTATATE and ⁶⁸Ga-Pentixafor PET images. In addition, in five patients, the SUVmax and TBR values in ⁶⁸Ga-FAPI-46 PET images were significantly higher than those in ¹⁸F-FDG PET images for lymph nodes and bone metastases. Although the SUVmax in ⁶⁸Ga-FAPI-46 and ¹⁸F-FDG PET images for liver metastases was comparable, ⁶⁸Ga-FAPI- 46 had a significantly higher TBR than ¹⁸F-FDG.

Conclusion: Our findings suggest that FAPI PET/CT is not suitable for evaluating GBM and Ewing sarcoma but generally outperforms ¹⁸F-FDG PET/CT in various types of breast cancer, gastrointestinal, gynecological, PTC and MTC. However, larger trials are needed to validate these preliminary findings.

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使用 68Ga-FAPI-46 PET/CT 检测各种癌症类型的初步临床经验。

目的：大量研究表明，镓-68标记的成纤维细胞活化蛋白抑制剂（68Ga-FAPI）正电子发射断层扫描/计算机断层扫描（PET/CT）可获得肿瘤内的高示踪摄取和正常组织作为背景的低摄取，从而能够很好地观察癌症微环境中的病灶。本研究旨在比较新型68Ga-FAPI-46 PET与常规氟-18-氟脱氧葡萄糖（18F-FDG）PET以及其他少数68Ga-DOTATATE/68Ga-Pentixafor PET/CT在评估不同类型癌症时的适用性：对组织病理学确诊为分化良好的腺癌、甲状腺髓样癌 (MTC)、甲状腺乳头状癌 (PTC)、宫颈癌、胃癌、多形性胶质母细胞瘤 (GBM)、结肠癌、尤文肉瘤和乳腺癌的 11 例患者（6 男 5 女；平均年龄：53 岁，范围：10-58 岁）进行了回顾性分析。这些患者接受了 PET/CT 扫描，使用了四种不同的放射性同位素（9 种 18F-FDG、11 种 68Ga- FAPI、3 种 68Ga-DOTATATE 和 1 种 68Ga-Pentixafor）。对患者的 PET/CT 图像进行目视评估以检测癌症，并通过图像衍生指标（如靶-背景比（TBR）和最大标准化摄取值（SUVmax））对复发和转移进行半定量分析：对11名患者的研究显示，68Ga-FAPI-46比其他示踪剂更能有效地检测转移灶，与18F-FDG相比，淋巴结中检测到的转移灶为55个对49个，肝脏中检测到的转移灶为4个对3个，骨骼中检测到的转移灶为4个对3个。在68Ga-DOTATATE和68Ga-Pentixafor PET图像中未观察到明显差异。此外，在5例患者中，68Ga-FAPI-46 PET图像中淋巴结和骨转移的SUVmax和TBR值明显高于18F-FDG PET图像。虽然68Ga-FAPI-46和18F-FDG PET图像用于肝转移的SUVmax相当，但68Ga-FAPI-46的TBR明显高于18F-FDG：我们的研究结果表明，FAPI PET/CT 不适用于评估 GBM 和尤文肉瘤，但在各种类型的乳腺癌、胃肠道癌、妇科肿瘤、PTC 和 MTC 中，FAPI PET/CT 通常优于 18F-FDG PET/CT。不过，还需要更大规模的试验来验证这些初步发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic journal of nuclear medicine 医学-核医学

CiteScore

1.40

自引率

6.70%

发文量

审稿时长

>12 weeks

期刊介绍： The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and cover the scientific and professional interests of physicians, in the field of nuclear medicine and in medicine in general. The journal may publish papers of nuclear medicine and also papers that refer to related subjects as dosimetry, computer science, targeting of gene expression, radioimmunoassay, radiation protection, biology, cell trafficking, related historical brief reviews and other related subjects. Original papers are preferred. The journal may after special agreement publish supplements covering important subjects, dully reviewed and subscripted separately.