Same-day dual-tracer PET/CT imaging with [68 Ga]Ga-FAPI-04 following [18F]FDG finds answers in patients presenting with negative or equivocal [18F]FDG.
IF 2.5 4区 医学Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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引用次数: 0
Abstract
Objective: Gallium-68-labelled fibroblast activation protein inhibitor ([68 Ga]Ga-FAPI) is a tumour-stromal imaging agent showing complementary value alongside fluorine-18 fluorodeoxyglucose ([18F]FDG) in cancer imaging. This study investigated the feasibility of a same-day dual-tracer positron emission tomography/computed tomography (PET/CT) protocol with [68 Ga]Ga-FAPI-04 following [18F]FDG in patients presenting with negative or equivocal [18F]FDG.
Methods: Patients with negative or equivocal [18F]FDG findings underwent dual-tracer PET/CT (named FDG-mixed FAPI PET/CT, abbreviated to mFAPI PET/CT) on the same day, with [68 Ga]Ga-FAPI-04 administered 4.0-7.75 h following [18F]FDG injection. Lesion detection rates and lesion-to-background uptake ratios (LBRs) were compared between [18F]FDG and mFAPI PET/CT.
Results: Forty-four patients were included in the analysis. The mFAPI PET was superior to [18F]FDG PET for primary tumour detection (86.2% [25/29] vs. 37.9% [11/29], P < 0.001), and showed higher LBRs (P < 0.001) in various types of cancer. For metastatic lesions detection, mFAPI PET yielded a greater number of positive lesions (90.3% [317/351] vs. 44.7% [157/351], P < 0.001) and higher LBRs than [18F]FDG in most lesions, especially in lymph node, peritoneal, and liver metastases (all P < 0.05). The mFAPI PET/CT scans had a prominent impact on patients with negative or equivocal [18F]FDG in different clinical situations, including characterizing suspicious lesions in 88.9% (8/9), locating the primary site in 46.2% (6/13), upgrading of tumour staging in 81.8% (9/11), and identification of recurrence in 81.8% (9/11).
Conclusions: A same-day dual-tracer PET/CT protocol with [68 Ga]Ga-FAPI-04 following [18F]FDG is feasible for enhancing the ability to identify indeterminate lesions, localize unknown malignant primary tumour sites, and accurately provide staging and restaging in patients presenting with negative or equivocal [18F]FDG.
Trial registration: NCT05034146. Registered February 23, 2021.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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