RT Journal Article
SR Electronic
T1 Oncologic Staging with <sup>68</sup>Ga-FAPI PET/CT Demonstrates a Lower Rate of Nonspecific Lymph Node Findings Than <sup>18</sup>F-FDG PET/CT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1906
OP 1909
DO 10.2967/jnumed.123.265751
VO 64
IS 12
A1 Demmert, Tristan T.
A1 Pomykala, Kelsey L.
A1 Lanzafame, Helena
A1 Pabst, Kim M.
A1 Lueckerath, Katharina
A1 Siveke, Jens
A1 Umutlu, Lale
A1 Hautzel, Hubertus
A1 Hamacher, Rainer
A1 Herrmann, Ken
A1 Fendler, Wolfgang P.
YR 2023
UL http://jnm.snmjournals.org/content/64/12/1906.abstract
AB Nonspecific lymph node uptake on 18F-FDG PET/CT imaging is a significant pitfall for tumor staging. Fibroblast activation protein α expression on cancer-associated fibroblasts and some tumor cells is less sensitive to acute inflammatory stimuli, and fibroblast activation protein–directed PET may overcome this limitation. Methods: Eighteen patients from our prospective observational study underwent 18F-FDG and 68Ga fibroblast activation protein inhibitor (FAPI) PET/CT scans within a median of 2 d (range, 0–22 d). Lymph nodes were assessed on histopathology and compared with SUV measurements. Results: On a per-patient basis, lymph nodes were rated malignant in 10 (56%) versus 7 (39%) patients by 18F-FDG PET/CT versus 68Ga-FAPI PET/CT scans, respectively, with a respective accuracy of 55% versus 94% for true lymph node metastases. Five of 6 (83%) false-positive nodes on the 18F-FDG PET/CT scans were rated true negative by the 68Ga-FAPI PET/CT scans. On a per-lesion basis, tumor detection rates were similar (85/89 lesions, 96%). Conclusion: 68Ga-FAPI PET/CT imaging demonstrated higher accuracy for true nodal involvement and therefore has the potential to replace 18F-FDG PET/CT imaging for cancer staging.