RT Journal Article
SR Electronic
T1 FAPI-74 PET/CT Using Either <sup>18</sup>F-AlF or Cold-kit <sup>68</sup>Ga-labeling: Biodistribution, Radiation Dosimetry and Tumor Delineation in Lung Cancer Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.120.245084
DO 10.2967/jnumed.120.245084
A1 Frederik Giesel
A1 Sebastian Adeberg
A1 Mustafa Syed
A1 Thomas Lindner
A1 Luis David Jimenez
A1 Eleni Mavriopoulou
A1 Fabian Staudinger
A1 Eric Tonndorf-Martini
A1 Sebastian Regnery
A1 Stefan Rieken
A1 Rami ElShafie
A1 Manuel Röhrich
A1 Paul Flechsig
A1 Andreas Kluge
A1 Annette Altmann
A1 Juergen Debus
A1 Uwe A. Haberkorn
A1 Clemens Kratochwil
YR 2020
UL http://jnm.snmjournals.org/content/early/2020/09/18/jnumed.120.245084.abstract
AB 68Ga-FAPI-2/4/46 have already been proposed as promising PET-tracers. However, the short half-life of 68Ga (T1/2 68 min) creates problems with manufacture and delivery. 18F (T1/2 110 min) labeling would result in a more practical large scale production and a cold-kit formulation would improve the spontaneous availability. The NOTA-chelator ligand FAPI-74 can be labeled with both 18F-AlF (Aluminum-Fluoride) and 68Ga. Here we describe the in-vivo evaluation of 18F-FAPI-74 and a proof-of-mechanism of 68Ga-FAPI-74 labeled at ambient temperature. Methods: In ten patients with lung cancer PET-scans were acquired at 10 min, 1h and 3H after administration of 259±26 MBq 18F-FAPI-74. Physiological biodistribution and tumor uptake were semi-quantitatively evaluated based on SUV at each time-point. Absorbed doses were evaluated using OLINDA/EXM 1.1 and QDOSE dosimetry software with the dose calculator IDAC-Dose 2.1. Identical methods were used to evaluate one exam after injection of 263 MBq 68Ga-FAPI-74. Results: The highest contrast was achieved 1 h p.i. in primary tumors, lymph node and distant metastases with SUVmax &gt;10, respectively. The effective dose per 100 MBq administered activity of 18F-FAPI-74 was 1.4±0.2 mSv and for 68Ga-FAPI-74 it was 1.6 mSv. Thus, the radiation burden of a diagnostic 18F-FAPI-74 PET-scan is even lower than that of PET-scans with 18F-FDG and other 18F-tracers; 68Ga-FAPI-74 is comparable to other 68Ga-ligands. FAPI-PET/CT supported target volume definition for guiding radiotherapy. Conclusion: High contrast and low radiation burden of FAPI-74 PET/CT favors multiple clinical applications. Centralized large-scale production of 18F-FAPI-74 or decentralized cold-kit labeling of 68Ga-FAPI-74 allows flexible routine use.