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Research ArticleTheranostics

68Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer

Clemens Kratochwil, Paul Flechsig, Thomas Lindner, Labidi Abderrahim, Annette Altmann, Walter Mier, Sebastian Adeberg, Hendrik Rathke, Manuel Röhrich, Hauke Winter, Peter K. Plinkert, Frederik Marme, Matthias Lang, Hans-Ulrich Kauczor, Dirk Jäger, Jürgen Debus, Uwe Haberkorn and Frederik L. Giesel
Journal of Nuclear Medicine June 2019, 60 (6) 801-805; DOI: https://doi.org/10.2967/jnumed.119.227967
Clemens Kratochwil
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Paul Flechsig
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
2Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
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Thomas Lindner
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Labidi Abderrahim
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Annette Altmann
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
3Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany
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Walter Mier
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Sebastian Adeberg
4Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
5Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
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Hendrik Rathke
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Manuel Röhrich
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Hauke Winter
2Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
6Department of Surgery, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany
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Peter K. Plinkert
7Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Frederik Marme
8Department Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
9Department Obstetrics and Gynecology, University Hospital Mannheim, Mannheim, Germany
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Matthias Lang
10Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Hans-Ulrich Kauczor
2Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
11Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
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Dirk Jäger
12Department of Medical Oncology and Internal Medicine VI, National Center for Tumor Diseases, University Hospital Heidelberg, Germany
13Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany; and
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Jürgen Debus
4Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
5Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
14Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg, Germany
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Uwe Haberkorn
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
2Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
3Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany
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Frederik L. Giesel
1Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Figures

  • FIGURE 1.
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    FIGURE 1.

    Neither mean, median, nor range of SUVmax of 68Ga-FAPI-04 PET differs significantly between primary tumors and metastases.

  • FIGURE 2.
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    FIGURE 2.

    Average SUVmax of 68Ga-FAPI PET/CT in various tumor entities. Low, intermediate, and high uptake was defined by cutoff at SUVs 6 and 12. By comparison, average background (blood pool) was found to have SUV 1.4. Ca = cancer; CCC = cholangiocellular carcinoma; CUP = carcinoma of unknown primary; HCC = hepatocellular carcinoma; NET = neuroendocrine tumor.

  • FIGURE 3.
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    FIGURE 3.

    Maximum-intensity projections of 68Ga-FAPI PET/CT in patients reflecting 15 different histologically proven tumor entities (sorted by uptake in descending order). Ca = cancer; CCC = cholangiocellular carcinoma; CUP = carcinoma of unknown primary; MTC = medullary thyroid cancer; NET = neuroendocrine tumor.

  • FIGURE 4.
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    FIGURE 4.

    Maximum-intensity projection (A) of patient with colorectal carcinoma. Because of low physiologic background uptake, tiny lesions in lung (B) and liver (D) were detected by 68Ga-FAPI-04 PET/CT and measured in dedicated CT of lung (C) and hepatic MRI (E) with long-axis diameters of 1 cm. *Primary tumor in left colon flexure. Red arrow = unspecific uptake in uterus.

  • FIGURE 5.
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    FIGURE 5.

    Among others, one clinical application for 68Ga-FAPI PET/CT can be to improve gross tumor volume delineation in preparation for external-beam radiotherapy—in this case, squamous cell carcinoma of neck with local lymph node metastases. From left to right: whole-body maximum-intensity projections, coronal PET slice through head/neck tumor, its fusion with coregistered CT, PET-segmented target-volume definition for external-beam radiotherapy.

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Journal of Nuclear Medicine: 60 (6)
Journal of Nuclear Medicine
Vol. 60, Issue 6
June 1, 2019
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68Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer
Clemens Kratochwil, Paul Flechsig, Thomas Lindner, Labidi Abderrahim, Annette Altmann, Walter Mier, Sebastian Adeberg, Hendrik Rathke, Manuel Röhrich, Hauke Winter, Peter K. Plinkert, Frederik Marme, Matthias Lang, Hans-Ulrich Kauczor, Dirk Jäger, Jürgen Debus, Uwe Haberkorn, Frederik L. Giesel
Journal of Nuclear Medicine Jun 2019, 60 (6) 801-805; DOI: 10.2967/jnumed.119.227967

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68Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer
Clemens Kratochwil, Paul Flechsig, Thomas Lindner, Labidi Abderrahim, Annette Altmann, Walter Mier, Sebastian Adeberg, Hendrik Rathke, Manuel Röhrich, Hauke Winter, Peter K. Plinkert, Frederik Marme, Matthias Lang, Hans-Ulrich Kauczor, Dirk Jäger, Jürgen Debus, Uwe Haberkorn, Frederik L. Giesel
Journal of Nuclear Medicine Jun 2019, 60 (6) 801-805; DOI: 10.2967/jnumed.119.227967
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