68Ga-FAPI PET/CT Versus 68Ga-DOTATATE PET/CT in the Evaluation of a Patient With Neuroendocrine Tumor

Kömek, Halil; Gündoğan, Cihan; Can, Canan

doi:10.1097/rlu.0000000000003490

Cited by 29 publications

(29 citation statements)

References 9 publications

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“…4). This patient suffered from neuroendocrine urothelial carcinoma and the favorable strong uptake demonstrates the potential of FAPI in neuroendocrine tumors, which are knowingly associated with the development of fibrosis [23,24] and, therefore, presenting an auspicious target which has been reported in different case reports [25,26].…”

Section: Discussionmentioning

confidence: 78%

“…Indications for performing FAP imaging include insufficient delineation, inconclusive findings, or the need to select target-positive patients for last-line experimental FAP-radioligand therapy. Six out of these 55 patients were already investigated under a different scientific scope (25,26, Röhrich and Syed et al currently under review). All patients gave written informed consent to undergo 68 Ga-FAPI-PET/CT on an individual patient basis following national regulations and the Declaration of Helsinki.…”

Section: Patient Cohortmentioning

confidence: 99%

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FAP imaging in rare cancer entities—first clinical experience in a broad spectrum of malignancies

Dendl

Finck

Giesel

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose 68 Ga-FAPI (fibroblast activation protein inhibitor) is a rapidly evolving and highly promising radiotracer for PET/CT imaging, presenting excellent results in a variety of tumor entities, particularly in epithelial carcinomas. This retrospective analysis sought to evaluate the potential and impact of FAPI-PET/CT in rare cancer diseases with respect to improvement in staging and therapy, based on tracer uptake in normal organs and tumors. Material and methods Fifty-five patients with rare tumor entities, defined by a prevalence of 1 person out of 2000 or less, received a 68 Ga-FAPI-PET/CT scan. Fourteen women and 41 men (median age 60) were included within the following subgroups: cancer of unknown primary (n = 10), head and neck cancer (n = 13), gastrointestinal and biliary-pancreatic cancer (n = 17), urinary tract cancer (n = 4), neuroendocrine cancer (n = 4), and others (n = 7). Tracer uptake was quantified by standardized uptake values SUVmax and SUVmean and the tumor-to-background ratio (TBR) was determined (SUVmax tumor/SUVmean organ). Results In 20 out of 55 patients, the primary tumor was identified and 31 patients presented metastases (n = 88), characterized by a high mean SUVmax in primary (10.1) and metastatic lesions (7.6). The highest uptake was observed in liver metastases (n = 6) with a mean SUVmax of 9.8 and a high TBR of 8.7, closely followed by peritoneal carcinomatosis (n = 16) presenting a mean SUVmax of 9.8 and an excellent TBR of 29.6. In terms of the included subgroups, the highest uptake regarding mean SUVmax was determined in gastrointestinal and biliary-pancreatic cancer with 9.8 followed closely by urinary tract cancer with 9.5 and head and neck cancer (9.1). Conclusion Due to excellent tumor visualization and, thereby, sharp contrasts in terms of high TBRs in primary and metastatic lesions in different rare malignancies, 68 Ga-FAPI-PET/CT crystallizes as a powerful and valuable imaging tool, particularly with respect to epithelial carcinomas, and therefore an enhancement to standard diagnostics imaging methodologies. The realization of further and prospective studies is of large importance to confirm the potential of FAP imaging in oncology.

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Section: Discussionmentioning

confidence: 78%

Section: Patient Cohortmentioning

confidence: 99%

FAP imaging in rare cancer entities—first clinical experience in a broad spectrum of malignancies

Dendl

Finck

Giesel

et al. 2021

Eur J Nucl Med Mol Imaging

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“…In addition, biopsies of the primary were not always feasible, such as in subjects diagnosed with CUP (patients #6, #11). Moreover, novel radioligands, such as fibroblast activation proteintargeting compounds, may also allow for further insights into pathophysiology of high grade NET/NEC relative to the reference standard 18 F-FDG [27].…”

Section: Discussionmentioning

confidence: 99%

CXCR4-Directed PET/CT in Patients with Newly Diagnosed Neuroendocrine Carcinomas

et al. 2021

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We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer 68Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard 18F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-naïve patients with histologically proven NEC, who underwent 18F-FDG and CXCR4-directed PET/CT for staging and therapy planning. The images were analyzed on a per-patient and per-lesion basis and compared to immunohistochemical staining (IHC) of CXCR4 from PET-guided biopsies. 68Ga-Pentixafor visualized tumor lesions in 10/11 subjects, while18F-FDG revealed sites of disease in all 11 patients. Although weak to moderate CXCR4 expression could be corroborated by IHC in 10/11 cases, 18F-FDG PET/CT detected significantly more tumor lesions (102 vs. 42; total lesions, n = 107; p < 0.001). Semi-quantitative analysis revealed markedly higher 18F-FDG uptake as compared to 68Ga-Pentixafor (maximum and mean standardized uptake values (SUV) and tumor-to-background ratios (TBR) of cancerous lesions, SUVmax: 12.8 ± 9.8 vs. 5.2 ± 3.7; SUVmean: 7.4 ± 5.4 vs. 3.1 ± 3.2, p < 0.001; and, TBR 7.2 ± 7.9 vs. 3.4 ± 3.0, p < 0.001). Non-invasive imaging of CXCR4 expression in NEC is inferior to the reference standard 18F-FDG PET/CT.

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“…Furthermore, one exemplary patient posed to present equally strong uptake in the tumorous lesion only 10 minutes after tracer administration compared with 1-hour, proving the feasibility of FAPI-PET/CT for rapid and adequate images, which may enable reduced radiation burden and improved practical implementation (10,11,12,13) (Figure 4). This patient suffered from neuroendocrine urothelial carcinoma and the favorable strong uptake demonstrates the potential of FAPI in neuroendocrine tumors, which are knowingly associated with the development of brosis (21,22) and, therefore, presenting an auspicious target which has been reported in different case reports (23,24).…”

Section: Discussionmentioning

confidence: 79%

FAP-Imaging in Rare Cancer Entities - First Clinical Experience in a Broad Spectrum of Malignancies

Dendl

Finck

Giesel

et al. 2021

Preprint

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Purpose: 68Ga-FAPI (fibroblast activation protein inhibitor) is a rapidly evolving and highly promising radiotracer for PET/CT imaging, presenting excellent results in a variety of tumor entities, particularly in epithelial carcinomas. This retrospective analysis sought to evaluate the potential and impact of FAPI-PET/CT in rare cancer diseases with respect to improvement in staging and therapy, based on tracer uptake in normal organs and tumors.Material and Methods: 55 patients with rare tumor entities, defined by a prevalence of 1 person out of 2000 or less, received a 68Ga-FAPI-PET/CT scan. 14 women and 41 men (median age 60) were included within the following subgroups: cancer of unknown primary (n=10), head-and-neck-cancer (n=13), gastro-intestinal and biliary-pancreatic cancer (n=17), urinary tract cancer (n=4), neuroendocrine cancer (n=4) and others (n=7). Tracer uptake was quantified by standardized uptake values SUVmax and SUVmean and the tumor-to-background ratio (TBR) was determined (SUVmax tumor/ SUVmean organ). Results: In 20 out of 55 patients the primary tumor was identified and 31 patients presented metastases (n=88), characterized by a high mean SUVmax in primary (10.1) and metastatic lesions (7.6). Highest uptake was observed by liver metastases (n=6) with a mean SUVmax of 9.8 and a high TBR of 8.7, closely followed by peritoneal carcinomatosis (n=16) presenting a mean SUVmax of 9.8 and an excellent TBR of 29.6. In terms of the included subgroups the highest uptake regarding mean SUVmax was determined in gastro-intestinal and biliary-pancreatic cancer with 9.8 followed closely by urinary tract cancer with 9.5 and head-and-neck cancer (9.1). Conclusion Due to excellent tumor visualization and, thereby, sharp contrasts in terms of high TBRs in primary and metastatic lesions in different rare malignancies, 68Ga-FAPI-PET/CT crystallizes as a powerful and valuable imaging tool, particularly with respect to epithelial carcinomas, and therefore an enhancement to standard diagnostics imaging methodologies. The realization of further and prospective studies is of large importance to confirm the potential of FAP-imaging in oncology.

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68Ga-FAPI PET/CT Versus 68Ga-DOTATATE PET/CT in the Evaluation of a Patient With Neuroendocrine Tumor

Cited by 29 publications

References 9 publications

FAP imaging in rare cancer entities—first clinical experience in a broad spectrum of malignancies

FAP imaging in rare cancer entities—first clinical experience in a broad spectrum of malignancies

CXCR4-Directed PET/CT in Patients with Newly Diagnosed Neuroendocrine Carcinomas

FAP-Imaging in Rare Cancer Entities - First Clinical Experience in a Broad Spectrum of Malignancies

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