PurposeThe present retrospective analysis sought to compare the relative diagnostic efficacy of [68Ga]Ga-DOTA-FAPI-04 to that of [18F]FDG PET/CT as a means of detecting bone metastases in patients with a range of cancer types.MaterialsIn total, 30 patients with bone metastases associated with different underlying malignancies were retrospectively enrolled. All patients had undergone [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT, and the McNemar test was used to compare the relative diagnostic performance of these two imaging modalities. The maximum standard uptake value (SUVmax) was used to quantify radiotracer uptake by metastatic lesions, with the relative uptake associated with these two imaging strategies being compared via the Mann-Whitney U test. The cohort was further respectively divided into two (osteolytic and osteoblastic bone metastases) and three clinical subgroups (lung cancer, thyroid cancer, and liver cancer).Results[68Ga]Ga-DOTA-FAPI-04 PET/CT was found to be significantly more sensitive as a means of diagnosing bone metastases relative to [18F]FDG PET/CT ([109/109] 100% vs [89/109] 81.7%; P< 0.01), consistent with the significantly increased uptake of [68Ga]Ga-DOTA-FAPI-04 by these metastatic lesions relative to that of [18F]FDG (n=109, median SUVmax, 9.1 vs. 4.5; P< 0.01). [68Ga]Ga-DOTA-FAPI-04 accumulation was significantly higher than that of [18F]FDG in both osteolytic (n=66, median SUVmax, 10.6 vs 6.1; P < 0.01), and osteoblastic metastases (n=43, median SUVmax, 7.7 vs 3.7; P < 0.01). [68Ga]Ga-DOTA-FAPI-04 uptakes were significantly higher than that of [18F]FDG in bone metastases from lung cancer (n = 62, median SUVmax, 10.7 vs 5.2; P < 0.01), thyroid cancer (n = 18, median SUVmax, 5.65 vs 2.1; P < 0.01) and liver cancer (n = 12, median SUVmax, 5.65 vs 3.05; P < 0.01). However, [68Ga]Ga-DOTA-FAPI-04 detected 10 false-positive lesions, while only 5 false-positive were visualized by [18F]FDG PET/CT.Conclusion[68Ga]Ga-DOTA-FAPI-04 PET/CT exhibits excellent diagnostic performance as a means of detecting bone metastases, and is superior to [18F]FDG PET/CT in this diagnostic context. Furthermore, [68Ga]Ga-DOTA-FAPI-04 tracer uptake levels are higher than those of [18F]FDG for most bone metastases. However, owing to the potential for false-positive bone lesions, it is critical that physicians interpret all CT findings with caution to ensure diagnostic accuracy.
Purpose Evaluation of the potential value of [68Ga]Ga-DOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) and [18F]FDG PET/CT in detection of differentiated thyroid cancer (DTC) metastases. Methods [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT scans were performed on suspected metastatic DTC patients. Maximum standard uptake value (SUVmax) was used to quantify the uptake of positive lesions. Histopathology or follow-up images were used as the standard for final diagnosis.Results A total of 35 DTC patients underwent [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT scans in the same time period. Average SUVmax of [68Ga]Ga-DOTA-FAPI-04 uptake by DTC lesions was low (average SUVmax<7). The difference in detection rate of SUVmax of[68Ga]Ga-DOTA-FAPI-04compared with that of[18F]FDG in bone metastases was statistically significant (P=0.000, 0.049). There were differences in the detection rate of other distant and lymph node metastases, and SUVmax, with no statistical significance (P>0.05). The specificity, accuracy, and positive predictive value of [68Ga]Ga-DOTA-FAPI-04 in the diagnosis of lymph node lesions were higher than those of [18F]FDG PET/CT, and the difference was statistically significant (c2=16.583,c2=9.910,c2=7.548,c2=2.781, P<0.05). There were no statistically significant differences in sensitivity, specificity, accuracy, and positive and negative predictive value of the two groups in the diagnosis of distant metastases (c2=0.440,c2=4.956,c2=0.013,c2=1.194,c2=2.618,P>0.05). Conclusion [68Ga]Ga-DOTA-FAPI-04 has certain advantages over [18F]FDG PET/CT in detecting lymph node and bone metastases. It has the same ability to detect other distant metastases and can be used as a supplementary imaging method for DTC.
Subcutaneous Ewing sarcoma is very rare. This report presents the case of a 23-year-old woman with a history of primary subcutaneous Ewing sarcoma who recently found a gradually increasing mass. Recurrent subcutaneous Ewing sarcoma was thus suspected. 18F-FDG PET/CT was performed and showed an FDG-avid mass in her buttocks. Subsequent histopathological and immunohistochemical tests were consistent with subcutaneous Ewing sarcoma.
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