scholarly journals 18F-NOTA-FAPI-04 uptake in metastatic lesions on PET/CT imaging can distinguish different pathological types of lung cancer

2021 ◽  
Author(s):  
Yuchun Wei ◽  
Kai Cheng ◽  
Zheng Fu ◽  
Jinsong Zheng ◽  
Zhengshuai Mu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Bone Metastases ◽  
Fibroblast Activation Protein ◽  
Ct Imaging ◽  
Primary Tumors ◽  
Fibroblast Activation ◽  
Metastatic Lesions ◽  
Pathological Type ◽  
Pet Ct

Abstract Purpose Radionuclide-labeled fibroblast-activation-protein inhibitor 04 (FAPI-04) as a positron emission tomography (PET) imaging tracer can reveal the localized expression of fibroblast activation protein (FAP), a cell-surface serine protease that is highly upregulated in more than 90% of epithelial carcinomas. In this study, we quantified the 18F-NOTA-FAPI-04 uptake on PET/computed tomography (CT) imaging in different pathological types of lung cancer and metastatic tumors. Methods We prospectively enrolled 61 patients with histopathologically proven primary lung cancer with metastases.PET/CT scanning was performed before any antitumor therapy and 1hour after injection of 235.10 ± 3.89 MBq of 18F-NOTA-FAPI-04. Maximum standard uptake values (SUVmax) were calculated for comparison among primary and metastatic lesions. Results Sixty-one patients with adenocarcinoma (ADC, n = 30), squamous cell carcinoma (SCC, n = 17), and small cell lung cancer (SCLC, n = 14) were enrolled in this study, and 61 primary tumors and 199 metastases were evaluated. No difference in18F-NOTA-FAPI-04 uptake was observed among primary ADC, SCC, and SCLC tumors (P = 0.198).Additionally, no difference in uptake was found between primary and metastatic lesions of lung cancer with the same pathological type (P > 0.05).However, uptake did differ among metastases of differing pathological type (P < 0.001). The SUVmax of metastatic lymph nodes was highest for SCC, followed by ADC and then SCLC (P < 0.001).The SUVmax of bone metastases also was highest for SCC, followed by ADC and SCLC (P < 0.05), but no difference was observed between ADC and SCLC. The SUVmax of metastases in other organs was higher in SCC cases than in ADC cases, but did not differ between SCC and SCLC or ADC and SCLC. Bone metastases exhibited higher uptake than those of lymph nodes and other organs in SCC and ADC (P < 0.05), but not in SCLC. Conclusion 18F-NOTA-FAPI-04 PET/CT imaging revealed differences in FAP expression in metastases of lung cancer, with the highest expression specifically in bone metastases, and thus, may be valuable for distinguishing different pathological types of lung cancer.

scholarly journals [18F]AlF-NOTA-FAPI-04 PET/CT uptake in metastatic lesions on PET/CT imaging might distinguish different pathological types of lung cancer

2021 ◽  
Author(s):  
Yuchun Wei ◽  
Kai Cheng ◽  
Zheng Fu ◽  
Jinsong Zheng ◽  
Zhengshuai Mu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Tumor Microenvironment ◽  
Lymph Nodes ◽  
Bone Metastases ◽  
Primary Lung Cancer ◽  
Ct Scanning ◽  
Ct Imaging ◽  
Primary Tumors ◽  
Metastatic Lesions ◽  
Pet Ct

Abstract Purpose Heterogeneity is found in the tumor microenvironment among different pathological types of tumors. Radionuclide-labeled fibroblast-activation-protein inhibitor (FAPI), as an important tracer for non-invasive imaging of the tumor microenvironment, can be used to evaluate the expression of FAP in cancer-associated fibroblasts, macrophages, and tumor cells. Our aim was to explore the ability of [18F]AlF-NOTA-FAPI-04 positron emission tomography (PET)/computed tomography (CT) to distinguish different types of lung cancer by evaluating the uptake of this tracer in primary and metastatic lesions. Methods We prospectively enrolled 61 patients with histopathologically proven primary lung cancer with metastases. PET/CT scanning was performed before any antitumor therapy and 1 h after injection of 235.10 ± 3.89 MBq of [18F]AlF-NOTA-FAPI-04. Maximum standard uptake values (SUVmax) were calculated for comparison among primary and metastatic lesions. Immunohistochemical staining for FAP was performed on tumor specimens. Results Sixty-one patients with adenocarcinoma (ADC, n = 30), squamous cell carcinoma (SCC, n = 17), and small cell lung cancer (SCLC, n = 14) were enrolled in this study, and 61 primary tumors and 199 metastases were evaluated. No difference in [18F]AlF-NOTA-FAPI-04 uptake was observed among primary ADC, SCC, and SCLC tumors (P = 0.198). Additionally, no difference in uptake was found between primary and metastatic lesions of lung cancer with the same pathological type (P > 0.05). However, uptake did differ among metastases of differing pathological types (P < 0.001). The SUVmax of metastatic lymph nodes was highest for SCC, followed by ADC and then SCLC (P < 0.001). The SUVmax of bone metastases also was highest for SCC, followed by ADC and SCLC (P < 0.05), but no difference was observed between ADC and SCLC. The SUVmax of metastases in other organs was higher in SCC cases than in ADC cases but did not differ between SCC and SCLC or ADC and SCLC. Bone metastases exhibited higher uptake than those of lymph nodes and other organs in SCC and ADC (P < 0.05) but not in SCLC. Positive correlations were found between FAPI uptake and FAP expression in surgical plus biopsy specimens (r = 0.439, P = 0.012) and surgical specimens (r = 0.938, P = 0.005). Conclusion [18F]AlF-NOTA-FAPI-04 PET/CT imaging revealed differences in FAP expression in metastases of lung cancer, with the highest expression specifically in bone metastases, and thus, may be valuable for distinguishing different pathological types of lung cancer.

scholarly journals Clinical Translational Evaluation of Al18F-NOTA-FAPI for Fibroblast Activation Protein Targeted Tumour Imaging

2021 ◽  
Author(s):  
Shuailiang Wang ◽  
Xin Zhou ◽  
Xiaoxia Xu ◽  
Jin Ding ◽  
Song Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fibroblast Activation Protein ◽  
Ct Imaging ◽  
Whole Body ◽  
Tumour Imaging ◽  
Tumour Detection ◽  
Fibroblast Activation ◽  
Tumour Bearing ◽  
Pet Ct ◽  
18F Fdg

Abstract PurposeIn this study, a novel Al18F-NOTA-FAPI probe was developed for fibroblast activation protein (FAP) targeted tumour imaging, which was available to achieve curie level radioactivity by automatic synthesizer. The tumour detection efficacy of Al18F-NOTA-FAPI was further validated both in preclinical and clinical translational studies. MethodsThe radiolabeling procedure of Al18F-NOTA-FAPI was optimized. Cell uptake and competitive binding assay were completed with U87MG and A549 cell lines, to evaluate the affinity and specificity of Al18F-NOTA-FAPI probe. The biodistribution, pharmacokinetics, radiation dosimetry and tumour imaging efficacy of Al18F-NOTA-FAPI probe were researched with healthy Kunming (KM) and/or U87MG model mice. After the approval of ethical committee, Al18F-NOTA-FAPI probe was translated into clinical for the PET/CT imaging of first 10 cancer patients. ResultsThe radiolabeling yield of Al18F-NOTA-FAPI was 33.8 ± 3.2% through manually operation (n = 10), with the radiochemical purity over than 99% and the specific activity of 9.3-55.5 MBq/nmol. Whole body effective dose of Al18F-NOTA-FAPI was estimated to be 1.24E-02 mSv/MBq, lower than several other FAPI probes ( 68Ga-FAPI-04, 68Ga-FAPI-46 and 68Ga-FAPI-74). In U87MG tumour bearing mice, Al18F-NOTA-FAPI showed good tumor detection efficacy from the results of micro PET/CT imaging and biodistribution studies. In organ biodistribution study of human patients, Al18F-NOTA-FAPI showed lower SUVmean than 2-[18F]FDG in most organs, especially in liver (1.1 ± 0.2 vs. 2.0 ± 0.9), brain (0.1 ± 0.0 vs. 5.9 ± 1.3), and bone marrow (0.9 ± 0.1 vs. 1.7 ± 0.4). Meanwhile, Al18F-NOTA-FAPI do not show extensive bone uptakes, and was able to find out more tumour lesions than 2-[18F]FDG in the PET/CT imaging of several patients. ConclusionAl18F-NOTA-FAPI probe was successfully fabricated and applied in fibroblast activation protein targeted tumour PET/CT imaging, which showed excellent imaging quality and tumour detection efficacy in U87MG tumour bearing mice as well as in human cancer patients.

scholarly journals FAPI PET/CT in the Diagnosis of Abdominal and Pelvic Tumors

2022 ◽  
Vol 11 ◽  
Author(s):  
Tianshuo Yang ◽  
Long Ma ◽  
Haodong Hou ◽  
Feng Gao ◽  
Weijing Tao
Keyword(s):  
Fdg Pet ◽  
Tumor Staging ◽  
Fibroblast Activation Protein ◽  
Research Progress ◽  
Gastric Mucus ◽  
Primary Tumors ◽  
Fibroblast Activation ◽  
Pelvic Tumors ◽  
Pet Ct ◽  
Fdg Pet Ct

Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) is currently a standard imaging examination used in clinical practice, and plays an essential role in preoperative systemic evaluation and tumor staging in patients with tumors. However, 18F-FDG PET/CT has certain limitations in imaging of some tumors, like gastric mucus adenocarcinoma, highly differentiated hepatocellular carcinoma, renal cell carcinoma, and peritoneal metastasis. Therefore, to search for new tumor diagnosis methods has always been an important topic in radiographic imaging research. Fibroblast activation protein (FAP) is highly expressed in many epithelial carcinomas, and various isotope-labelled fibroblast activation protein inhibitors (FAPI) show lower uptake in the brain and abdominal tissues than in tumor, thus achieving high image contrast and good tumor delineation. In addition to primary tumors, FAPI PET/CT is better than FDG PET/CT for detecting lymph nodes and metastases. Additionally, the highly selective tumor uptake of FAPI may open up new application areas for the non-invasive characterization, staging of tumors, as well as monitoring tumor treatment efficacy. This review focuses on the recent research progress of FAPI PET/CT in the application to abdominal and pelvic tumors, with the aim of providing new insights for diagnostic strategies for tumor patients, especially those with metastases.

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.

Can PET/CT substitute for bone scintigraphy in assessment of bone metastases in lung cancer patients?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7203-7203
Author(s):  
H. Watanabe ◽  
S. Monzawa ◽  
S. Adachi ◽  
A. Hamanaka ◽  
Y. Kitamura ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Bone Scintigraphy ◽  
False Positive ◽  
Gold Standard ◽  
Ct Imaging ◽  
Whole Body ◽  
Lung Cancer Patients ◽  
Pet Ct

7203 Background: Bone is a frequent site of lung cancer metastasis. However, false positive lesions detected by conventional bone scintigraphy often become problematic. We compared the efficacy of whole-body [18F]-2-Fluoro-2-deoxy- D- glucose PET/CT imaging and conventional bone scintigraphy for assessment of bone lesions in lung cancer patients on an individual patient basis. Methods: The study population comprised 106 consecutive patients with suspected or proven lung cancer (73 men and 33 women; age range: 40 to 85 years) who underwent both whole-body PET/CT imaging and conventional bone scintigraphy using 740 MBq of Tc-99m hydroxymethylene diphosphonate for cancer staging. Diagnostic radiologists interpreted and assessed all images on a patient-by-patient basis. Clinical information and the findings of follow-up imaging studies were used as the gold standard for the identification of bone metastases. Results: On the basis of the gold standard, 11 of the 106 patients were identified as having bone metastases. Bone scintigraphy showed a sensitivity of 67% (7/11) while that of PET/CT was 100% (11/11) for detection of bone metastases. Seven of these 11 patients were deemed positive based on both bone scintigraphy and PET/CT. Bone metastases not identified on bone scintigraphy were detected on PET/CT in another four patients. For 39 of 95 patients without bone metastases, the assessment was false-positive for bone scintigraphy but negative for PET/CT. In two of the 39 patients, CT images of PET/CT could identify a benign fracture causing a false positive finding for bone scintigraphy. Conclusions: PET/CT might actually substitute for bone scintigraphy in lung cancer patients because of its superior ability to detect unsuspected bone metastases and to differentiate bone metastases from false positive lesions detected by bone scintigraphy. No significant financial relationships to disclose.

scholarly journals Noninvasive imaging of tumor progression, metastasis, and fibrosis using a nanobody targeting the extracellular matrix

2019 ◽  
Vol 116 (28) ◽  
pp. 14181-14190 ◽  
Author(s):  
Noor Jailkhani ◽  
Jessica R. Ingram ◽  
Mohammad Rashidian ◽  
Steffen Rickelt ◽  
Chenxi Tian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Extracellular Matrix ◽  
Ct Imaging ◽  
Ductal Adenocarcinoma ◽  
Primary Tumors ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Alternatively Spliced ◽  
Metastatic Sites

Extracellular matrix (ECM) deposition is a hallmark of many diseases, including cancer and fibroses. To exploit the ECM as an imaging and therapeutic target, we developed alpaca-derived libraries of “nanobodies” against disease-associated ECM proteins. We describe here one such nanobody, NJB2, specific for an alternatively spliced domain of fibronectin expressed in disease ECM and neovasculature. We showed by noninvasive in vivo immuno-PET/CT imaging that NJB2 detects primary tumors and metastatic sites with excellent specificity in multiple models of breast cancer, including human and mouse triple-negative breast cancer, and in melanoma. We also imaged mice with pancreatic ductal adenocarcinoma (PDAC) in which NJB2 was able to detect not only PDAC tumors but also early pancreatic lesions called pancreatic intraepithelial neoplasias, which are challenging to detect by any current imaging modalities, with excellent clarity and signal-to-noise ratios that outperformed conventional 2-fluorodeoxyglucose PET/CT imaging. NJB2 also detected pulmonary fibrosis in a bleomycin-induced fibrosis model. We propose NJB2 and similar anti-ECM nanobodies as powerful tools for noninvasive detection of tumors, metastatic lesions, and fibroses. Furthermore, the selective recognition of disease tissues makes NJB2 a promising candidate for nanobody-based therapeutic applications.

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.

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