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We sought to evaluate the performance of 68 Ga-DOTA-FAPI-04 ( 68 Ga-FAPI) PET/MR for the diagnosis of primary tumor and metastatic lesions in patients with gastric carcinomas and to compare the results with those of 18 F-FDG PET/CT. Methods: Twenty patients with histologically proven gastric carcinomas were recruited, and each patient underwent both 18 F-FDG PET/CT and 68 Ga-FAPI PET/MR. A visual scoring system was established to compare the detectability of primary tumors and metastases in different organs/regions (the peritoneum, abdominal lymph nodes, supradiaphragmatic lymph nodes, liver, ovary, bone, and other tissues). The original maximum standardized uptake value (SUVmax) and normalized SUVmax (calculated by dividing a lesion's original SUVmax with the mean SUV of the descending aorta) of selected lesions on both 18 F-FDG PET/CT and 68 Ga-FAPI PET/MR were measured.Original/normalized SUVmax-FAPI and SUVmax-FDG were compared for patient-based (including a single lesion with the highest activity uptake in each organ/region) and lesion-based (including all lesions [≤ 5] or the 5 lesions with highest activity [> 5]) analyses, respectively. Results:The 20 recruited patients (median age: 56.0 y; range: 29-70 y) included 9 men and 11 women, 14 patients for initial staging and 6 for recurrence detection. 68 Ga-FAPI PET was superior to 18 F-FDG PET for primary tumor detection (100.00% [14/14] vs 71.43% [10/14], p = 0.034), and the former had higher tracer uptake levels (p < 0.05). 68 Ga-FAPI PET was superior to 18 F-FDG PET in both patient-based and lesion-based evaluation except for the metastatic lesions in supradiaphragmatic lymph nodes and ovaries. Additionally, multiple sequences of MR images were beneficial for the interpretation of hepatic metastases in 3 patients, uterine and rectal metastases in 1 patient, ovarian lesions in 7 patients, and osseous metastases in 2 patients. Conclusion:68 Ga-FAPI PET/MR outperformed 18 F-FDG PET/CT in visualizing the primary and most metastatic lesions of gastric cancer, and might be a promising method with the potential of replacing 18 F-FDG PET/CT.

1 J. Magn. Reson. Imaging 2017;45:879-888.

BackgroundThe rational design of theranostic nanoprobe to present responsive effect of therapeutic potency and enhanced diagnostic imaging in tumor milieu plays a vital role for efficient personalized cancer therapy and other biomedical applications. We aimed to afford a potential strategy to pose both T1- and T2-weighted MRI functions, and thereby realizing imaging guided drug delivery and targeted therapy.ResultsTheranostic nanocomposites Mn-porphyrin&Fe3O4@SiO2@PAA-cRGD were fabricated and characterized, and the nanocomposites were effectively used in T1- and T2-weighted MRI and pH-responsive drug release. Fluorescent imaging also showed that the nanocomposites specifically accumulated in lung cancer cells by a receptor-mediated process, and were nontoxic to normal cells. The r2/r1 ratio was 20.6 in neutral pH 7.4, which decreased to 7.7 in acidic pH 5.0, suggesting the NCs could act as an ideal T1/T2 dual-mode contrast agent at acidic environments of tumor. For in vivo MRI, T1 and T2 relaxation was significantly accelerated to 55 and 37%, respectively, in the tumor after i.v. injection of nanocomposites.ConclusionThe synthesized nanocomposites exhibited highly sensitive MRI contrast function no matter in solution, cells or in vivo by synergistically enhancing positive and negative magnetic resonance imaging signals. The nanocomposites showed great potential for integrating imaging diagnosis and drug controlled release into one composition and providing real-time imaging with greatly enhanced diagnostic accuracy during targeted therapy. Electronic supplementary materialThe online version of this article (10.1186/s12951-018-0350-5) contains supplementary material, which is available to authorized users.

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Dopamine transporter (DAT) and glucose metabolism imaging have been applied in the diagnosis of Parkinson’s disease (PD). We explored the possibility of evaluating for PD with NeuroQ software by analyzing 11 C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane ( 11 C-CFT) and 18 F-FDG PET/CT. We retrospectively analyzed brain 11 C-CFT and 18 F-FDG PET/CT of 38 patients with parkinsonism, including 20 with PD, 10 with multiple system atrophy (MSA) and 8 with essential tremor (ET), and compared them with the PET/CT of 11 normal healthy controls (NC). PD patients were divided into mild and moderate-severe grade according to the Hoehn-Yahr (H&Y) scale. The 11 C-CFT uptake in the caudate nuclei (CN) and putamen (Pu) normalized with cerebellum (CN/Cb and Pu/Cb) were obtained with a manual method and NeuroQ software, and their diagnostic performance was compared. 18 F-FDG uptake of specific regions was also obtained with NeuroQ, and the enhancement effect for the differential diagnosis was evaluated. There was significant agreement between the manual method and the NeuroQ method for 11 C-CFT uptake by CN ( r 2 = 0.680) and Pu ( r 2 = 0.770). 11 C-CFT uptake by CN and Pu in PD and MSA patients was significantly lower compared to NC and ET patients. The cutoffs of CN/Cb and Pu/Cb for the distinction between PD and NC were 1.71 and 2.20, respectively. No difference in uptake ratios occurred between PD and MSA. 18 F-FDG uptake by the pons and cerebellum in the MSA group was markedly decreased. It was highly accurate in distinguishing between PD and MSA when combined with analysis of 11 C-CFT uptake. Pu/Cb decreased significantly in mild grade PD compared to NC group (1.92 ± 0.33 vs. 2.82 ± 0.43); however no statistically significant decrease in CN/Cb was observed until moderate-severe grade PD (1.43 ± 0.11 vs. 2.23 ± 0.36). In early asymmetric PD, a statistically significant difference could be seen with Pu/Cb between the symptomatic and asymptomatic side (2.17 ± 0.30 vs. 1.95 ± 0.22). 11 C-CFT and 18 F-FDG PET/CT can be analyzed quantitatively with NeuroQ software, which provides an accurate method for the diagnosis and severity evaluation of PD.

Purpose: To describe the uptake of 68 Gallium-labelled broblast activation protein inhibitor ( 68 Ga-FAPI) in bones and joints for better understanding of the role of 68 Ga-FAPI PET in benign and malignant bone lesions and joint diseases.Methods: All 129 68 Ga-FAPI PET/MR or PET/CT scans from June 1, 2020 to February 20, 2021 performed at our PET centre were retrospectively reviewed. Foci of elevated 68 Ga-FAPI uptake in bones and joints were identi ed. All lesions were divided into malignant and benign disease. Benign lesions included osteo brous dysplasia, periodontitis, degenerative bone diseases, arthritis, and other in ammatory or trauma-related abnormalities. The number, locations and SUVmax of all lesions were recorded and analysed.Results: Elevated uptake of 68 Ga-FAPI in/around bones and joints were found in 82 cases (63.57%). A total of 295 lesions were identi ed, including 94 (31.9%) malignant lesions (all were metastases) and 201 (68.1%) benign lesions. The benign lesions consisted of 13 osteo brous dysplasia, 48 degenerative bone disease, 33 periodontitis, 56 arthritis, and 51 other in ammatory or trauma-related abnormalities. Spine, shoulder joint, alveolar ridge, and pelvis were the most commonly involved locations. Bone metastases were mainly distributed in the spine, pelvis and ribs. Among benign diseases, periodontitis and arthritis are site-speci c. The mean SUVmax of bone metastases was signi cantly higher than that of benign diseases (7.14 ± 4.33 vs. 3.57 ± 1.60, p < 0.0001), but overlap existed. The differences in SUVmax among subgroups of benign diseases were statistically signi cant (p < 0.0001), with much higher uptake in periodontitis (4.45 ± 1.17). Conclusion: 68Ga-FAPI accumulated in both bone metastases and some benign diseases of bones and joints. Although the uptake of 68 Ga-FAPI was often higher in bone metastases, this nding cannot be used to distinguish between benign and malignant lesions.

MRI of hyperpolarized media, such as 129Xe and 3He, shows great potential for clinical applications. The optimal use of the available spin polarization requires accurate flip angle calibrations and T1 measurements. Traditional flip angle calibration methods are time-consuming and suffer from polarization losses during T1 relaxation. In this paper, we propose a method to simultaneously calibrate flip angles and measure T1 in vivo during a breath-hold time of less than 4 seconds. We demonstrate the accuracy, robustness and repeatability of this method and contrast it with traditional methods. By measuring the T1 of hyperpolarized gas, the oxygen pressure in vivo can be calibrated during the same breath hold. The results of the calibration have been applied in variable flip angle (VFA) scheme to obtain a stable steady-state transverse magnetization. Coupled with this method, the ultra-short TE (UTE) and constant VFA (CVFA) schemes are expected to give rise to new applications of hyperpolarized media.