2022 SNMMI Highlights Lecture: Oncology and Therapy, Part 1

Comparison of ⁶⁸Ga-FAPI and ¹⁸F-FDG PET/CT in gastric signet-ring cell carcinoma. Top: Example patients imaged with ¹⁸F-FDG (top row) and ⁶⁸Ga-FAPI (bottom row) PET/CT. Bottom: Comparative imaging in a single patient with ¹⁸F-FDG (left) and ⁶⁸Ga-FAPI (right) PET/CT. ⁶⁸Ga-FAPI imaging resulted in higher detection rates in primary tumors (73% vs 18%), local recurrence (100% vs 29%), nodal metastases (77% vs 23%), and distant metastases (93% vs 39%).

aPROMISE for rapid lesion detection and standardized quantitative evaluation for ¹⁸F-DCFPyL (PSMA) imaging in prostate cancer. In this example ¹⁸F-DCFPyL image (A), the aPROMISE tool performed both AI-based CT segmentation of bone and soft tissue (B) and hotspot detection/segmentation (C) to yield total PSMA SUV_mean, total PSMA tumor volume, and a total PSMA score. The time needed to score an ¹⁸F-DCFPyL scan using aPROMISE in metastatic disease was dramatically shorter (median, 1.4 min) than average manual reading time (∼15 min).

PSMA PET mapping of postoperative local recurrence compared with planning based on prostate fossa contouring guidelines for salvage radiation therapy. Patient example with: (left and middle) 2D heatmap of prostate bed recurrence on ⁶⁸Ga-PSMA-11 PET/CT and RTOG-based clinical treatment volume (CTV; green outline); (right) 3D heatmap of prostate bed recurrence on ⁶⁸Ga-PSMA-11 PET/CT and RTOG-based CTV, showing proximity to rectal and bladder walls. The authors concluded that PSMA PET–based data should inform the update of commonly used prostate bed contouring guidelines.

Prognostic utility of ⁶⁸Ga-NODAGA-E[c(RGDyK)]2 PET/CT integrin α_vβ₃ imaging in patients with neuroendocrine neoplasms (NENs). Example imaging in patients with a metastatic lung NEN (left) and a metastatic pancreatic NEN (right). Higher tracer uptake was significantly correlated with worse prognosis.