Comparison of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT in patients with non-small cell lung cancer

Abstract

In this study, we aimed to compare the diagnostic accuracy of 18 F−fluorodeoxyglucose ( 18 F-FDG) and Gallium-68 labeled fibroblast activator protein inhibitor ( 68 Ga-FAPI)-04 PET/CT in the tumor-node-metastasis (TNM) staging of patients with nonsmall cell lung cancer (NSCLC) and investigate whether adenocarcinoma (ADC) and squamous cell cancer (SCC) exhibit different uptake patterns on 68 Ga-FAPI-04 PET/CT. Materials and methodTwenty-nine patients with a histopathologically-confirmed diagnosis of NSCLC, who had no history of previous radiation therapy or chemotherapy and underwent 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT imaging between January 2021 and December 2021 were included in this retrospective study. Staging was performed using the 8th edition of the TNM staging system on both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT images. Standardized uptake value (SUV) max and tumor-to-background ratios (TBR) were calculated on primary lesions and metastases. ResultsThere was no statistically significant difference in primary lesions in terms of SUV max and TBR values. However, 68 Ga-FAPI-04 PET/CT was significantly superior to 18 F-FDG PET/CT in terms of the number of lymph nodes and bone metastases revealed. The SUV max and TBR values of lymph nodes, hepatic lesions and bone lesions were significantly higher on 68 Ga-FAPI-04 PET/ CT than on 18 F-FDG PET/CT. 68 Ga-FAPI-04 PET/CT changed the disease stage of three patients (10.9%). The diagnostic accuracy of 68 Ga-FAPI-04 PET/CT was 100%, whereas the diagnostic accuracy of 18 F-FDG PET/CT was 89.6% (P = 0.250). ConclusionAlthough 68 Ga-FAPI-04 PET/CT detected more lesions and higher diagnostic accuracy than 18 F-FDG PET/CT in NSCLC, neither method was statistically superior to each other in terms of diagnostic accuracy in TNM staging.

Comparison of the role of 18F-fluorodeoxyglucose PET/computed tomography and 68Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma

“…In addition, in volume-based evaluation; MTV, TLG and Hpeak values obtained from lymph nodes were found to be higher on FAPI imaging compared to FDG imaging. Although there is no study in the literature comparing lymph node metastases of only malignant mesothelioma patients, it has been reported that 68 Ga-FAPI-04 PET/CT is superior to 18 F-FDG PET/CT in detecting lymph node metastases in different tumor types and our findings support the literature [34–37].…”

“…This finding may be due to the small number of patients with bone metastases. Despite this, five new bone metastases were demonstrated in two patients with 68 Ga-FAPI-04 PET/CT, and an upstage was observed in one patient [35,39–41].…”

Superiority of 18F-FDG PET/CT to 68GA-FAPI PET/CT in Adrenocortical Tumor Imaging

“…9 In our previous studies with 68 Ga-FAPI-04 PET/CT in different tumor types, we reported its superiority over 18 F-FDG PET/CT in staging and detection of recurrence. 10,11 In this case, we demonstrated the superiority of 18 F-FDG PET/ CT in the detection of recurrence and metastases in adrenocortical carcinoma.…”

“…In the evaluation of a wide spectrum of adrenal gland pathology with PET/CT performed with different radiopharmaceuticals, the most useful imaging was found to be with 18 F-FDG, although it was not found to be specific 9 . In our previous studies with 68 Ga-FAPI-04 PET/CT in different tumor types, we reported its superiority over 18 F-FDG PET/CT in staging and detection of recurrence 10,11 . In this case, we demonstrated the superiority of 18 F-FDG PET/CT in the detection of recurrence and metastases in adrenocortical carcinoma.…”

The Role of 68Ga FAPI-04 and 18F-FDG PET/CT in Detecting Liver Metastases in Different Types of Cancer

“…This retrospective study included 63 patients with liver lesions who underwent 18 F-FDG PET/CT and 68 Ga-FAPI PET/CT in our clinic between May 2020 and May 2022. Some patients were from our previous prospective studies [12,13,14,15]. The inclusion criteria were as follows: both PET scans obtained at a maximum interval of 14 days, histopathologically confirmed primary diagnoses, age over 18 years; ECOG performance scores of 0-2, data that could be accessed retrospectively, and liver lesions evident on biopsy over at least 3-6 months of follow-up employing US, CT, MRI, PET/CT, and/or laboratory tests.…”