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Research ArticleBRIEF COMMUNICATION

Oncologic Staging with 68Ga-FAPI PET/CT Demonstrates a Lower Rate of Nonspecific Lymph Node Findings Than 18F-FDG PET/CT

Tristan T. Demmert, Kelsey L. Pomykala, Helena Lanzafame, Kim M. Pabst, Katharina Lueckerath, Jens Siveke, Lale Umutlu, Hubertus Hautzel, Rainer Hamacher, Ken Herrmann and Wolfgang P. Fendler
Journal of Nuclear Medicine December 2023, 64 (12) 1906-1909; DOI: https://doi.org/10.2967/jnumed.123.265751
Tristan T. Demmert
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Kelsey L. Pomykala
3Institute for AI in Medicine, University Medicine Essen, Essen, Germany;
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Helena Lanzafame
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Kim M. Pabst
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Katharina Lueckerath
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Jens Siveke
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
4Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany;
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Lale Umutlu
5Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; and
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Hubertus Hautzel
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Rainer Hamacher
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
6Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
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Ken Herrmann
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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Wolfgang P. Fendler
1Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany;
2German Cancer Consortium, Partner Site University Hospital Essen, and German Cancer Research Center, Essen, Germany;
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  • FIGURE 1.
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    FIGURE 1.

    Standards for Reporting of Diagnostic Accuracy Studies flow diagram.

  • FIGURE 2.
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    FIGURE 2.

    SUVpeak and TBR of 18 lymph nodes (1 node per patient). (A) SUVpeak of lymph nodes. (B) TBRmuscle with major pectoral muscle. (C) Blood TBR (TBRblood) with aorta as reference. Statistical significance of difference was assessed by Mann–Whitney U test.

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    FIGURE 3.

    Patient 10, 72-y-old man with urothelial carcinoma of bladder being evaluated for restaging after chemotherapy, showing mismatch of tracer-avid lymph node in 18F-FDG PET/CT and non–tracer-avid lymph node in 68Ga-FAPI PET/CT. Histopathology result was benign. 18F-FDG PET/CT images (A and B) and 68Ga-FAPI PET/CT images (C and D), maximum-intensity projections (A and D), axial CT (B and C, top), PET (B and C, middle), and fused PET/CT (B and C, bottom) are shown.

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    TABLE 1.

    Accuracy of 18F-FDG PET/CT Vs. 68Ga-FAPI PET/CT for Nodal Staging in 18 Patients

    TracerMalignantBenignStatistics
    18F-FDG
     PositiveTrue positive, n = 4False positive, n = 6Positive predictive value, 56%
     NegativeFalse positive, n = 2True negative, n = 6Negative predictive value, 89%
     StatisticsSensitivity, 66%Specificity, 50%Accuracy, 55%
    68Ga-FAPI
     PositiveTrue positive, n = 6False positive, n = 1Positive predictive value, 86%
     NegativeFalse positive, n = 0True negative, n = 11Negative predictive value, 100%
     StatisticsSensitivity, 100%Specificity, 92%Accuracy, 94%
    • Accuracy was tabulated on per-patient basis (1 node per patient).

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Journal of Nuclear Medicine: 64 (12)
Journal of Nuclear Medicine
Vol. 64, Issue 12
December 1, 2023
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Oncologic Staging with 68Ga-FAPI PET/CT Demonstrates a Lower Rate of Nonspecific Lymph Node Findings Than 18F-FDG PET/CT
Tristan T. Demmert, Kelsey L. Pomykala, Helena Lanzafame, Kim M. Pabst, Katharina Lueckerath, Jens Siveke, Lale Umutlu, Hubertus Hautzel, Rainer Hamacher, Ken Herrmann, Wolfgang P. Fendler
Journal of Nuclear Medicine Dec 2023, 64 (12) 1906-1909; DOI: 10.2967/jnumed.123.265751

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Oncologic Staging with 68Ga-FAPI PET/CT Demonstrates a Lower Rate of Nonspecific Lymph Node Findings Than 18F-FDG PET/CT
Tristan T. Demmert, Kelsey L. Pomykala, Helena Lanzafame, Kim M. Pabst, Katharina Lueckerath, Jens Siveke, Lale Umutlu, Hubertus Hautzel, Rainer Hamacher, Ken Herrmann, Wolfgang P. Fendler
Journal of Nuclear Medicine Dec 2023, 64 (12) 1906-1909; DOI: 10.2967/jnumed.123.265751
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Keywords

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