[68Ga]FAPI-PET/CT for radiation therapy planning in biliary tract, pancreatic ductal adeno-, and adenoidcystic carcinomas

Guberina, Nika; Kessler, Lukas; Pöttgen, Christoph; Guberina, Maja; Metzenmacher, Martin; Herrmann, Ken; Mucha, Maja; Rischpler, Christoph; Indenkämpen, Frank; Siveke, Jens T.; Treckmann, Jürgen; Umutlu, Lale; Kasper, Stefan; Fendler, Wolfgang P.; Stuschke, Martin

doi:10.1038/s41598-022-20447-6

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…Furthermore, 68 Ga-FAPI uptake can not only be seen in CAF, but also in non-malignant conditions, such as inflammatory lymph nodes, artherosclerosis, or surgical scars [59]. Nevertheless, the high tracer uptake is described in 68 Ga-FAPI PET images obtained from human PDAC patients [22,60]. CAFs have been identified as a target in tumor diagnosis and therapy, as they seem to play a key role in various parts of tumor development, such as tumor growth, metastasis formation, and the immune response [61,62].…”

Section: Discussionmentioning

confidence: 99%

Multiparametric Characterization of the DSL-6A/C1 Pancreatic Cancer Model in Rats

Schmidt,

Lindemeyer,

Raut

et al. 2024

Cancers

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The DSL-6A/C1 murine pancreatic ductal adenocarcinoma (PDAC) tumor model was established in Lewis rats and characterized through a comprehensive multiparametric analysis to compare it to other preclinical tumor models and explore potential diagnostic and therapeutical targets. DSL-6A/C1 tumors were histologically analyzed to elucidate PDAC features. The tumor microenvironment was studied for immune cell prevalence. Multiparametric MRI and PET imaging were utilized to characterize tumors, and 68Ga-FAPI-46-targeting cancer-associated fibroblasts (CAFs), were used to validate the histological findings. The histology confirmed typical PDAC characteristics, such as malformed pancreatic ductal malignant cells and CAFs. Distinct immune landscapes were identified, revealing an increased presence of CD8+ T cells and a decreased CD4+ T cell fraction within the tumor microenvironment. PET imaging with 68Ga-FAPI tracers exhibited strong tracer uptake in tumor tissues. The MRI parameters indicated increasing intralesional necrosis over time and elevated contrast media uptake in vital tumor areas. We have demonstrated that the DSL-6A/C1 tumor model, particularly due to its high tumorigenicity, tumor size, and 68Ga-FAPI-46 sensitivity, is a suitable alternative to established small animal models for many forms of preclinical analyses and therapeutic studies of PDAC.

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Section: Discussionmentioning

confidence: 99%

Multiparametric Characterization of the DSL-6A/C1 Pancreatic Cancer Model in Rats

Schmidt,

Lindemeyer,

Raut

et al. 2024

Cancers

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“…In particular, volumetric parameters derived from 18 F-FDG PET/CT have a great potential to improve the assessment of response to therapy [27][28][29]. In a recent study in patients with pancreatic cancer, it was reported that radiotherapy planning and evaluation of response to treatment improved significantly with volume-based 68 Ga-FAPI-04 PET/CT [30]. In our study similar to the literature, we found that 68 Ga-FAPI-04 PET/CT was superior to 18 F-FDG PET/CT in the volume-based evaluation of primary tumors and their metastases.…”

Section: Discussionmentioning

confidence: 99%

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

Güzel

Kömek

Can

et al. 2023

Nuclear Medicine Communications

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Objective In this study, we aimed to compare the role of 68 Ga-labeled FAP inhibitor ( 68 Ga-FAPI)-04 PET/ computed tomography (CT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma. Materials and methodsOur prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared. ResultsMore lesions were detected in 68 Ga-FAPI-04 PET/CT compared to 18 F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/ CT, upstage was observed according to tumor-nodemetastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin. ConclusionIn addition to the stage change with 68 Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases. Nucl Med Commun

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Implementation of PET/CT in radiation oncology—a patterns-of-care analysis of the German Society of Nuclear Medicine and the German Society of Radiation Oncology

Wegen,

Nestle,

Zamboglou

et al. 2024

Strahlenther Onkol

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Background The use of positron-emission tomography (PET)/computed tomography (CT) in radiation therapy (RT) has increased. Radiation oncologists (RadOncs) have access to PET/CT with a variety of tracers for different tumor entities and use it for target volume definition. The German Society of Nuclear Medicine (DGN) and the German Society of Radiation Oncology (DEGRO) aimed to identify current patterns of care in order to improve interdisciplinary collaboration. Methods We created an online survey on participating RadOncs’ use of PET tracers for different tumor entities and how they affect RT indication, dose prescription, and target volume definition. Further topics were reimbursement of PET/CT and organizational information (fixed timeslots and use of PET with an immobilization device [planning/RT-PET]). The survey contained 31 questions in German language (yes/no questions, multiple choice [MC] questions, multiple select [MS] questions, and free-text entry options). The survey was distributed twice via the DEGRO member mailing list. Results During the survey period (May 22–August 7, 2023) a total of 156 RadOncs (13% of respondents) answered the survey. Among these, 59% reported access to diagnostic PET/CT within their organization/clinic and 24% have fixed timeslots for their patients. 37% of survey participants can perform RT-PET and 29% have the option of providing a dedicated RT technician for planning PET. Besides [18F]-fluorodeoxyglucose (FDG; mainly used in lung cancer: 95%), diagnostic prostate-specific membrane antigen (PSMA)-PET/CT for RT of prostate cancer is routinely used by 44% of participants (by 64% in salvage RT). Use of amino acid PET in brain tumors and somatostatin receptor PET in meningioma is low (19 and 25%, respectively). Scans are reimbursed through private (75%) or compulsory (55%) health insurance or as part of indications approved by the German Joint Federal Committee (Gemeinsamer Bundesausschuss; 59%). 98% of RadOncs agree that PET impacts target volume definition and 62% think that it impacts RT dose prescription. Discussion This is the first nationwide survey on the role of PET/CT for RT planning among RadOncs in Germany. We find high acceptance of PET results for treatment decisions and target volume definition. Planning PET comes with logistic challenges for different healthcare settings (e.g., private practices vs. university hospitals). The decision to request PET/CT is often based on the possibility of reimbursement. Conclusion PET/CT has become an important tool for RadOncs, with several indications. However, access is still limited at several sites, especially for dedicated RT-PET. This study aims to improve interdisciplinary cooperation and adequate implementation of current guidelines for the treatment of various tumor entities.

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[68Ga]FAPI-PET/CT for radiation therapy planning in biliary tract, pancreatic ductal adeno-, and adenoidcystic carcinomas

Cited by 5 publications

References 40 publications

Multiparametric Characterization of the DSL-6A/C1 Pancreatic Cancer Model in Rats

Multiparametric Characterization of the DSL-6A/C1 Pancreatic Cancer Model in Rats

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

Implementation of PET/CT in radiation oncology—a patterns-of-care analysis of the German Society of Nuclear Medicine and the German Society of Radiation Oncology

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