[68Ga]Ga-DOTA-FAPI-04 PET/CT in The Staging of Gastric Cancer: Improved Diagnostic Efficacy Confirmed By Postoperative Histopathology

2021 ◽  
Author(s):  
Rong Lin ◽  
Zefang Lin ◽  
Zhenying Chen ◽  
Shan Zheng ◽  
Jiaying Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Response To Treatment ◽  
Diagnostic Efficacy ◽  
Primary Tumors ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
N Staging

Abstract Purpose This study aimed to compare the diagnostic performance of [68Ga]Ga-DOTA-FAPI-04 and [18F]-FDG PET/CT in the primary and metastatic lesions of gastric cancer. Methods Fifty-six patients with histologically proven gastric carcinomas were enrolled in this study. Each patient underwent both [18F]-FDG and [68Ga]Ga-FAPI-04 PET/CT within one week. Activity of tracer accumulation in lesions were assessed by maximum standardized uptake value (SUVmax) and TBR (lesions SUVmax/ ascending aorta SUVmean). Histological work-up including immunohistochemical staining for FAP served as a standard of reference. Results [68Ga]Ga-FAPI PET/CT is superior in detecting primary tumors both in patient-based (100% [45/45] vs. 97.8% [44/45]) and lesion-based analyses (97.8% [45/46] vs. 95.7% [44/46]), showing higher SUVmax (10.25 vs. 8.13, P = 0.004) and TBR (11.63 vs. 5.83, P < 0.001), compared with [18F]-FDG PET/CT. The specificity and positive predictive value of [68Ga]Ga-FAPI were significantly higher than that of [18F]-FDG (100.0% vs. 97.7%, P < 0.001; 100.0% vs. 57.1%, P = 0.001) in determining the lymph node (LN) metastases. [68Ga]Ga-FAPI PET/CT was superior to [18F]-FDG PET/CT in N-staging (47.1% [8/17] vs. 23.5% [4/17]), and in evaluation for LN, peritoneum and bone metastases. [68Ga]Ga-FAPI PET/CT detected positive recurrent lesions in all patients and showed more positive lesions and clearer tumor delineation. Two patients underwent follow-up [68Ga]Ga-FAPI PET/CT scans after chemotherapy, which both showed remission. Conclusions [68Ga]Ga-FAPI PET/CT can better detect primary gastric cancer and metastatic lesions in peritoneum, abdominal LNs and bone, showing high usefulness in guiding N staging. Furthermore, [68Ga]Ga-FAPI PET/CT provides more information for patients with recurrence detection and also has great potential in monitoring response to treatment.

scholarly journals The Potential Utility of 68Ga-FAPI-04 As a Novel Broad-spectrum Tumor and Inflammatory Imaging Agent - Comparison With 18F-FDG

2021 ◽  
Author(s):  
Lin Qiu ◽  
Lianjun Lan ◽  
Hanxiang Liu ◽  
Yingwei Wang ◽  
Jia Deng ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Fdg Pet ◽  
Detection Rate ◽  
Imaging Agent ◽  
Benign Tumors ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Objective: This study aimed to compare the diagnostic performance of 68Ga-FAPI-04 and 18F-FDG PET/CT in the patients with various oncological and non-oncological lesions. Patients and Methods: A total of 123 patients underwent contemporaneous 68Ga-FAPI-04 and 18F-FDG PET/CT were included in this prospective study. The maximum standard uptake value (SUVmax) was measured to compare oncological and non-oncological lesion uptake. The sensitivity, specificity, predictive values and accuracy of 18F-FDG and 68Ga-FAPI-04 PET/CT for detecting primary, metastatic, and non-oncological lesions were calculated and compared to evaluate the diagnostic efficacy. Results: The study subjects consisted of 123 patients (69 men and 54 women; mean age: 56.11±11.94). A total of 84 patients with 88 solid primary malignant tumors, 58 patients with 376 nodal metastases, 43 patients with 406 distant metastases, 8 patients with hematological neoplasms and 52 patients with 145 non-oncological lesions and benign tumors were detected. 68Ga-FAPI-04 PET/CT demonstrated a significantly higher uptake and detection rate for the primary (SUVmax: 10.98±5.83 vs. 8.36±6.43, p＜0.001; X2=0.538, p=0.021), nodal (SUVmax: 10.50±5.98 vs. 8.20±6.29, p=0.011; X2=2.067, p＜0.001) and distant metastatic lesions (SUVmax: 6.74±4.83 vs. 9.64±6.45; p＜0.001; X2=4.897, p＜0.001) of solid tumor than did 18F-FDG PET/CT. 68Ga-FAPI-04 PET/CT demonstrated a lower activity (SUVmax: 6.84±4.67 vs. 13.09±7.29, p＜0.001) and detection rate (X2=5.166, p＜0.001) for multiple myeloma and lymphoma compared to 18F-FDG PET/CT. 68Ga-FAPI-04 and 18F-FDG PET/CT PET/CT demonstrated a comparative diagnostic efficacy (SUVmax: 6.40±3.95 vs. 5.74±15.78, p = 0.729; X2 = 9.460, p = 0.007) for non-oncological lesion and benign tumor detection. Conclusions: Except for myeloma and lymphoma, 68Ga-FAPI-04 PET/CT showed a superior diagnostic efficacy for detecting various primary and metastatic lesions than 18F-FDG PET/CT. A comparative diagnostic utility for non-oncological lesion detection was obtained with both tracers. 68Ga-FAPI-04 could be used as a broad-spectrum tumor and inflammatory imaging agent in the clinical especially for various solid tumors and non-oncological lesions.

scholarly journals The clinical impact of incidental sellar uptake on F-18 FDG PET/CT

2019 ◽  
Vol 6 (2) ◽  
pp. IJE15
Author(s):  
Zehra Pınar Koç ◽  
Pelin Özcan Kara ◽  
Emel Sezer ◽  
Kadir Eser ◽  
Anıl Özgür
Keyword(s):  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Sellar Region ◽  
Primary Tumors ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Frequent Finding ◽  
Metastatic Involvement ◽  
Fdg Pet Ct

Aim: The most frequent finding associated with incidental fluorodeoxyglucose (FDG) uptake in sellar region in oncologic F-18 FDG PET/CT is adenoma. However, reports of metastatic involvement exist. We investigated the clinical significance of incidental FDG uptake in this region. Materials & method: 34 patients with several primary tumors who were referred for staging, restaging or treatment response via F-18 FDG PET/CT were included. Images were reviewed and patients with significant FDG uptake in the sellar region were referred. Results: Mean lesion diameter was 11.9 ± 4.9 mm and mean standardized uptake value was 8.2 ± 6.1. Thirteen patients underwent MRI, and the others underwent follow-up F-18 FDG PET/CT. MRI revealed metastatic involvement in nine patients and macro- or micro-adenoma in four. Metastatic patients also had other lesions, yet management did not change. Conclusion: FDG accumulation in the sellar region might be associated with metastasis or adenoma. However, it did not change management. Future studies are warranted.

scholarly journals Pulmonary Nodule and Mass: Superiority of MRI of Diffusion-Weighted Imaging and T2-Weighted Imaging to FDG-PET/CT

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5166
Author(s):  
Katsuo Usuda ◽  
Masahito Ishikawa ◽  
Shun Iwai ◽  
Aika Yamagata ◽  
Yoshihito Iijima ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Signal Intensity ◽  
Contrast Ratio ◽  
Standardized Uptake Value ◽  
Operating Characteristics ◽  
Diagnostic Efficacy ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Ct And Mri

The purpose of this retrospective study was to compare the diagnostic efficacy of FDG-PET/CT and MRI in discriminating malignant from benign pulmonary nodules and masses (PNMs). There were 278 lung cancers and 50 benign PNMs that were examined by FDG-PET/CT and MRI. The T2 contrast ratio (T2 CR) was designated as the ratio of T2 signal intensity of PNM divided by T2 signal intensity of the rhomboid muscle. The optimal cut-off values (OCVs) for differential diagnosis were 3.605 for maximum standardized uptake value (SUVmax), 1.459 × 10−3 mm2/s for apparent diffusion coefficient (ADC), and 2.46 for T2 CR. Areas under the receiver operating characteristics curves were 67.5% for SUVmax, 74.3% for ADC, and 72.4% for T2 CR, respectively. The sensitivity (0.658) of SUVmax was significantly lower than that (0.838) of ADC (p < 0.001) and that (0.871) of T2 CR (p < 0.001). The specificity (0.620) of SUVmax was that the same as (0.640) ADC and (0.640) of T2 CR. The accuracy (0.652) of SUVmax was significantly lower than that (0.808) of ADC (p < 0.001) and that (0.835) of T2 CR (p < 0.001). The sensitivity and accuracy of DWI and T2WI in MRI were significantly higher than those of FDG-PET/CT. Ultimately, MRI can replace FDG PET/CT for differential diagnosis of PNMs saving healthcare systems money while not sacrificing the quality of care.

scholarly journals Preoperative Standardized Uptake Value of Metastatic Lymph Nodes Measured by 18F-FDG PET/CT Improves the Prediction of Prognosis in Gastric Cancer

Medicine ◽  
2015 ◽  
Vol 94 (26) ◽  
pp. e1037 ◽  
Author(s):  
Bong-Il Song ◽  
Hae Won Kim ◽  
Kyoung Sook Won ◽  
Seung Wan Ryu ◽  
Soo Sang Sohn ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Pet Ct ◽  
18F Fdg ◽  
Prediction Of Prognosis ◽  
Fdg Pet Ct

Standardized uptake value differences between primary and metastatic lesions in 18F-FDG PET/CT of patients with lung cancer

2014 ◽  
Vol 56 (11) ◽  
pp. 1329-1335 ◽  
Author(s):  
Nobuyuki Kosaka ◽  
Tatsuro Tsuchida ◽  
Kazunobu Tsuji ◽  
Kazuhiro Shimizu ◽  
Hirohiko Kimura
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Value Differences ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (48) ◽  
pp. 84473-84488 ◽  
Author(s):  
Mingxu Luo ◽  
Hongmei Song ◽  
Gang Liu ◽  
Yikai Lin ◽  
Lintao Luo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
N Staging

scholarly journals The F-18 FDG PET/CT evaluation of the metastatic adrenal lesions of the non-lung cancer tumors compared with pathology results

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Zehra Pınar Koç ◽  
Pınar Pelin Özcan ◽  
Emel Sezer ◽  
Kadir Eser ◽  
Tuba Kara
Keyword(s):  
Lung Cancer ◽  
Adrenal Gland ◽  
Fdg Pet ◽  
Cancer Metastasis ◽  
Unknown Primary ◽  
Adrenal Tumors ◽  
Primary Tumors ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background The aim of this study was to evaluate the role of F-18 FDG PET/CT imaging in the diagnosis of primary and metastatic adrenal tumors that originate from non-lung cancer primary tumors. Results F-18 FDG PET/CT images of patients (8 male and 6 female; mean: 55.36 ± 16.2 years old) who attended with the diagnosis of primary or adrenal metastatic lesions other than lung cancer metastasis were evaluated in a retrospective manner. The diameter of the adrenal lesions was mean: 23.93 ± 36.6 mm with SUVmax levels of mean: 9.98 ± 7.8. The primary site of 2/3 of the patients with unknown primary was the adrenal gland, and in one of the patients primary tumor remained unknown during follow-up. Conclusions According to the results of this study, F-18 FDG PET/CT has high diagnostic performance in the diagnosis of the adrenal gland primary and metastatic lesions, which originate from non-lung cancer tumors. Further studies in the larger series are warranted.

Comparison of the Diagnostic Efficacy of 68Ga-FAPI-04 PET/MRI and 18F-FDG PET/CT in Patients With Pancreatic Cancer

2021 ◽  
Author(s):  
Zeyu Zhang ◽  
Guorong Jia ◽  
Guixia Pan ◽  
Kai Cao ◽  
Qinqin Yang ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Multiple Sequence ◽  
Primary Tumors ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract PurposeTo assess the diagnostic performance of 68Ga-FAPI-04 (68Ga-FAPI) PET/MR for primary as well as metastatic lesions in pancreatic cancer patients and to compare the results with those of 18F-FDG PET/CT.MethodsProspectively, we evaluated 31 patients suspected to have pancreatic malignancy. Within one week, each patient underwent both 18F-FDG PET/CT and 68Ga-FAPI PET/MR. Comparisons of the detection abilities and the standardized uptake values (SUVs) for primary tumors, lymph nodes, as well as hepatic metastases were conducted for the two imaging approaches.ResultsTwenty-eight pancreatic cancer patients and three pancreatitis ones were enrolled. 68Ga-FAPI and 18F-FDG exhibited equivalent (100%) detection rates for primary tumors. The SUVs of primary tumors on 68Ga-FAPI PET were markedly higher than those on 18F-FDG (p < 0.05). Fifteen pancreatic cancer patients were accompanied by pancreatic parenchymal uptake, whereas 18F-FDG PET images showed parenchymal uptake in 3 patients only (53.57% vs. 10.71%, p < 0.001). The number of positive lymph nodes detected was higher for 68Ga-FAPI than for 18F-FDG PET (31 vs. 26), led to N upstaging in 27.27% (3/11) of patients, however, the difference was not statistically significant (p = 0.053). 18F-FDG PET was able to detect more liver metastases than 68Ga-FAPI, and 68Ga-FAPI uptake of metastatic tumors was significantly lower than 18F-FDG (6.13 ± 1.63 vs. 8.09 ± 1.68, p < 0.001). In larger liver metastatic lesions, 68Ga-FAPI tended to distribute around the periphery of the lesions. In addition, multiple sequence MR imaging was helpful for finding more micrometastases.Conclusion68Ga-FAPI PET demonstrated equivalent detection rate with 18F-FDG for primary tumors of pancreatic cancer, and its percentage of pancreatic parenchymal uptake caused by inflammation was higher. It might be better in the detection of suspicious lymph node metastases. The MR multiple sequence imaging of integrated PET/MR was helpful for detecting tiny liver metastases.

scholarly journals Head-to-head comparison of [68Ga]Ga-FAPI-04 and [18F]-FDG PET/CT in evaluating the extent of disease in gastric adenocarcinoma

2021 ◽  
Author(s):  
Jonathan Kuten ◽  
Charles Levine ◽  
Ofer Shamni ◽  
Sharon Pelles ◽  
Ido Wolf ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Fdg Pet ◽  
Detection Rate ◽  
Standardized Uptake Value ◽  
Lesion Detection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Extent Of Disease

Abstract Background [18F]-Fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) may sometimes be suboptimal for imaging gastric adenocarcinoma. The recently introduced [68Ga]Ga-FAPI-04 (FAPI) PET/CT targets tumor stroma and has shown considerable potential in evaluating the extent of disease in a variety of tumors. Methods We performed a head-to-head prospective comparison of FAPI and FDG PET/CT in the same group of 13 patients with gastric adenocarcinoma who presented for either initial staging (n = 10) or restaging (n = 3) of disease. Lesion detection and maximum standardized uptake value (SUVmax) were compared between the two types of radiotracers. Results All ten primary gastric tumors were FAPI-positive (100% detection rate), whereas only five were also FDG-positive (50%). SUVmax was not significantly different, but the tumor-to-background ratio was higher for FAPI (mean, median, and range of 4.5, 3.2, and 0.8–9.7 for FDG and 12.9, 11.9, and 2.2–23.9 for FAPI, P = 0.007). The level of detection of regional lymph node involvement was comparable. FAPI showed a superior detection rate for peritoneal carcinomatosis (100% vs. none). Two patients with widespread peritoneal carcinomatosis underwent a follow-up FAPI scan after chemotherapy: one showed partial remission and the other showed progressive disease. Conclusions The findings of this pilot study suggest that FAPI PET/CT outperforms FDG PET/CT in detecting both primary gastric adenocarcinoma and peritoneal carcinomatosis from gastric cancer. FAPI PET/CT also shows promise for monitoring response to treatment in patients with peritoneal carcinomatosis from gastric cancer; however, larger trials are needed to validate these preliminary findings.

scholarly journals Head-to-Head Comparison of [68Ga]Ga-FAPI-04 and [18F]-FDG PET/CT in Evaluating the Extent of Disease in Gastric Adenocarcinoma

2021 ◽  
Author(s):  
Jonathan Kuten ◽  
Charles Levine ◽  
Ofer Shamni ◽  
Sharon Pelles ◽  
Ido Wolf ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Fdg Pet ◽  
Detection Rate ◽  
Standardized Uptake Value ◽  
Lesion Detection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Extent Of Disease

Abstract Background[18F]-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) may sometimes be suboptimal for imaging gastric adenocarcinoma. The recently introduced [68Ga]Ga-FAPI-04 (FAPI) PET/CT targets tumor stroma and has shown considerable potential in evaluating the extent of disease in a variety of tumors.MethodsWe performed a head-to-head prospective comparison of FAPI and FDG PET/CT in the same group of 13 patients with gastric adenocarcinoma who presented for either initial staging (n = 10) or restaging (n = 3) of disease. Lesion detection and maximum standardized uptake value (SUVmax) were compared between the two types of radiotracers.ResultsAll ten primary gastric tumors were FAPI-positive (100% detection rate), whereas only five were also FDG-positive (50%). SUVmax was not significantly different, but the tumor-to-background ratio was higher for FAPI (mean, median, and range of 4.5, 3.2, and 0.8-9.7 for FDG and 12.9, 11.9, and 2.2-23.9 for FAPI, P = 0.007). The level of detection of regional lymph node involvement was comparable. FAPI showed a superior detection rate for peritoneal carcinomatosis (100% vs. none). Two patients with widespread peritoneal carcinomatosis underwent a follow-up FAPI scan after chemotherapy: one showed partial remission and the other showed progressive disease.ConclusionsThe findings of this study suggest that FAPI PET/CT outperforms FDG PET/CT in detecting both primary gastric adenocarcinoma and peritoneal carcinomatosis from gastric cancer. FAPI PET/CT also shows promise for monitoring response to treatment in patients with peritoneal carcinomatosis from gastric cancer, however, larger trials are needed to validate these findings.

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