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 Head-to-head intra-individual comparison of biodistribution and tumor uptake of 68Ga-FAPI and 18F-FDG PET/CT in cancer patients

2021 ◽  
Author(s):  
Frederik L. Giesel ◽  
Clemens Kratochwil ◽  
Joel Schlittenhardt ◽  
Katharina Dendl ◽  
Matthias Eiber ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Standard Of Care ◽  
Blood Pool ◽  
Tracer Uptake ◽  
Time Interval ◽  
Tumor Uptake ◽  
Primary Tumors ◽  
Individual Comparison ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose FAPI ligands (fibroblast activation protein inhibitor), a novel class of radiotracers for PET/CT imaging, demonstrated in previous studies rapid and high tumor uptake. The purpose of this study is the head-to-head intra-individual comparison of 68Ga-FAPI versus standard-of-care 18F-FDG in PET/CT in organ biodistribution and tumor uptake in patients with various cancers. Material and Methods This international retrospective multicenter analysis included PET/CT data from 71 patients from 6 centers who underwent both 68Ga-FAPI and 18F-FDG PET/CT within a median time interval of 10 days (range 1–89 days). Volumes of interest (VOIs) were manually drawn in normal organs and tumor lesions to quantify tracer uptake by SUVmax and SUVmean. Furthermore, tumor-to-background ratios (TBR) were generated (SUVmax tumor/ SUVmax organ). Results A total of 71 patients were studied of, which 28 were female and 43 male (median age 60). In 41 of 71 patients, the primary tumor was present. Forty-three of 71 patients exhibited 162 metastatic lesions. 68Ga-FAPI uptake in primary tumors and metastases was comparable to 18F-FDG in most cases. The SUVmax was significantly lower for 68Ga-FAPI than 18F-FDG in background tissues such as the brain, oral mucosa, myocardium, blood pool, liver, pancreas, and colon. Thus, 68Ga-FAPI TBRs were significantly higher than 18F-FDG TBRs in some sites, including liver and bone metastases. Conclusion Quantitative tumor uptake is comparable between 68Ga-FAPI and 18F-FDG, but lower background uptake in most normal organs results in equal or higher TBRs for 68Ga-FAPI. Thus, 68Ga-FAPI PET/CT may yield improved diagnostic information in various cancers and especially in tumor locations with high physiological 18F-FDG uptake.

scholarly journals Detection of additional primary malignancies: the role of CT and PET/CT combined with multiple percutaneous biopsy

2019 ◽  
Vol 52 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Tiago Kojun Tibana ◽  
Rômulo Florêncio Tristão Santos ◽  
Adalberto Arão Filho ◽  
Bernardo Bacelar ◽  
Leticia de Assis Martins ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Fdg Pet ◽  
Percutaneous Biopsy ◽  
Primary Tumors ◽  
Additional Lesion ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Pathology Reports ◽  
Fdg Pet Ct

Abstract Objective: To evaluate the imaging findings of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and computed tomography (CT) in patients with additional primary tumors, correlating the results with those of the method used in order to elucidate the diagnosis and of the pathology reports. Materials and Methods: We retrospectively analyzed the medical records, pathology reports and images of 11 patients who underwent CT, 18F-FDG PET/CT, or both. We included patients with at least two tumors, with confirmed distinct histopathological profiles, at different sites. Patients in whom there was no diagnostic confirmation were excluded, as were those in whom the additional lesion was suspected of being a metastasis of the first. Results: New primary malignancies were identified in 11 patients, one new tumor being found in 10 and two new tumors being found in 1. The confirmed sites of the additional malignancies were the lung, kidney, prostate, jejunum, and breast. Single or multiple percutaneous biopsies were performed in 10 patients, and 1 patient underwent a surgical procedure for diagnostic and therapeutic purposes. The tumors were metachronous in 6 cases and synchronous in 5. Conclusion: CT and 18F-FDG PET-CT combined with multiple percutaneous biopsy could facilitate the diagnosis of additional lesions, thus optimizing the treatment and follow-up of the affected patients.

[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.

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