Article Figures & Data
Figures
- FIGURE 1.
(A) Axial single-tracer [18F]-FDG PET/CT scan showing primary tumor at gastroesophageal junction and metastases in left adrenal gland and liver. (B) Maximum-intensity projection of single-tracer PET images displaying high uptake in brain tissue, tracer accumulation around injection site at right elbow, lymph node (LN) metastasis in left upper mediastinum, multiple abdominal LN metastases, and liver metastases. Additional benign accumulation of [18F]-FDG is visible, caused by right-sided thoracolumbar osteoarthritis. (C) Transverse section of dual-tracer [18F]-FDG/[68Ga]Ga-FAPI-46 PET/CT scan of same patient as in A and B with mediastinal LN metastasis. (D) As all images were visually normalized to uptake in liver, maximum-intensity projection of dual-tracer PET/CT in same patient shows less pronounced tracer accumulation in brain tissue than does single-tracer PET/CT. In addition to lesions detected with single-tracer PET/CT, further abdominal LN metastasis and liver metastases are visualized via [18F]-FDG/[68Ga]Ga-FAPI-46 PET/CT. Focal tracer accumulation in right vein angle is due to intravenous tracer accumulation from former tracer depot at right elbow.
- FIGURE 2.
Box plot of TBRs calculated from peak and maximum CR of tumors (CRpeakT and CRmaxT, respectively) (A) and peak and maximum CR of metastasis (CRpeakM and CRmaxM, respectively) (B) vs. mean CR of background cerebellum (CRmeanC), liver (CRmeanL), and mediastinal blood pool (CRmeanBP). Plots clearly display tendency of median TBRs to be higher on dual-tracer [18F]-FDG/[68Ga]Ga-FAPI-46 PET/CT than on single-tracer [18F]-FDG PET/CT. These results were most obvious in TBRs of malignant tissue with cerebellum or liver as background.
Tables
- TABLE 1.
Patient Characteristics, Scan Data, and Lesion Detection with Single- vs. Dual-Tracer PET/CT
Characteristic Mean No. of patients Single tracer Dual tracer Age (y) 72.5 ± 12.3 Detected malignant findings on PET/CT Tumors (n = 7) Oropharyngeal cancer 2 2 Cancer of mouth floor 1 1 Esophageal cancer 4 4 Metastasis (n = 12) Lymph node metastasis Cervical 4 4 Mediastinal 1 2* Mesenterial 1 1 Retroperitoneal 1 1 Parailiac 1 1 Pleural metastasis 1 1 Liver metastasis 1 1* Adrenal gland metastasis 1 1 PET/CT Time between [68Ga]Ga- FAPI-46 injection and scan (min) 18.2 ± 20.1 Time between [18F]-FDG and [68Ga]Ga-FAPI-46 scan (min) 81.3 ± 38.1 * More metastases were detected in drainage area of mediastinal lymph nodes and liver on dual-tracer PET/CT than on single-tracer PET/CT.
- TABLE 2.
TBRs of CRs Measured in Tumors, Metastasis, and Background on [18F]-FDG/[68Ga]Ga-FAPI-46 PET/CT and [18F]-FDG PET/CT
TBR Dual tracer Single tracer Wilcoxon signed-rank test CR tumor-to-background CR peak tumor/CR mean cerebellum 3.7 ± 1.7 1.8 ± 1.0 z = −2.37, P = 0.008; r = 0.89 CR peak tumor/CR mean liver 8.0 ± 4.1 4.7 ± 2.3 z = −2.20, P = 0.016; r = 0.83 CR peak tumor/CR mean mediastinal blood pool 8.2 ± 3.7 6.1 ± 2.8 z = −2.20, P = 0.016; r = 0.83 CR maximum tumor/CR mean cerebellum 4.3 ± 1.8 2.1 ±1.1 z = −2.37, P = 0.008; r = 0.89 CR maximum tumor/CR mean liver 9.3 ± 4.2 5.7 ± 2.6 z = −2.20, P = 0.016; r = 0.83 CR maximum tumor/CR mean mediastinal blood pool 9.5 ± 3.7 7.3 ± 3.2 z = −2.03, P = 0.023; r = 0.76 CR metastasis-to-background CR peak metastasis/CR mean cerebellum 2.2 ± 1.2 0.8 ± 0.5 z = −3.06, P ≤ 0.001; r = 0.88 CR peak metastasis/CR mean liver 2.9 ± 1.0 1.9 ± 1.0 z = −3.06, P ≤ 0.001; r = 0.88 CR peak metastasis/CR mean mediastinal blood pool 3.9 ± 1.9 3.1 ± 1.8 z = −2.51, P = 0.005; r = 0.72 CR maximum metastasis/CR mean cerebellum 2.9 ± 1.6 1.1 ± 0.6 z = −3.06, P ≤ 0.001; r = 0.88 CR maximum metastasis/CR mean liver 3.9 ± 1.4 2.5 ± 1.2 z = −2.82, P ≤ 0.001; r = 0.81 CR maximum metastasis/CR mean mediastinal blood pool 5.2 ± 2.4 4.0 ± 2.2 z = −2.35, P = 0.008; r = 0.68 Data are mean ± SD.
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