68Ga-fibroblast activation protein inhibitor PET/CT on gross tumour volume delineation for radiotherapy planning of oesophageal cancer

Zhao, Liang; Chen, Shanyu; Chen, Sijia; Pang, Yizhen; Dai, Yun; Hu, Shenping; Lin, Lianbo; Fu, Lirong; Sun, Long; Wu, Hua; Chen, Haojun; Qi, Lin

doi:10.1016/j.radonc.2021.02.015

Cited by 39 publications

(51 citation statements)

References 37 publications

(78 reference statements)

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“…These findings were subsequently confirmed by Zhao et al in 21 patients with newly diagnosed esophageal cancer who underwent both 18 F-FDG and 68 Ga-FAPI-PET/CT scans. FAPI imaging showed favorable SUV metrics, TBRs and a superior target volume delineation [ 98 ].…”

Section: Malignant Conditionsmentioning

confidence: 99%

FAP and FAPI-PET/CT in Malignant and Non-Malignant Diseases: A Perfect Symbiosis?

Dendl

Koerber

Kratochwil

et al. 2021

Cancers

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A fibroblast activation protein (FAP) is an atypical type II transmembrane serine protease with both endopeptidase and post-proline dipeptidyl peptidase activity. FAP is overexpressed in cancer-associated fibroblasts (CAFs), which are found in most epithelial tumors. CAFs have been implicated in promoting tumor cell invasion, angiogenesis and growth and their presence correlates with a poor prognosis. However, FAP can generally be found during the remodeling of the extracellular matrix and therefore can be detected in wound healing and benign diseases. For instance, chronic inflammation, arthritis, fibrosis and ischemic heart tissue after a myocardial infarction are FAP-positive diseases. Therefore, quinoline-based FAP inhibitors (FAPIs) bind with a high affinity not only to tumors but also to a variety of benign pathologic processes. When these inhibitors are radiolabeled with positron emitting radioisotopes, they provide new diagnostic and prognostic tools as well as insights into the role of the microenvironment in a disease. In this respect, they deliver additional information beyond what is afforded by conventional FDG PET scans that typically report on glucose uptake. Thus, FAP ligands are considered to be highly promising novel tracers that offer a new diagnostic and theranostic potential in a variety of diseases.

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Section: Malignant Conditionsmentioning

confidence: 99%

FAP and FAPI-PET/CT in Malignant and Non-Malignant Diseases: A Perfect Symbiosis?

Dendl

Koerber

Kratochwil

et al. 2021

Cancers

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“…Regarding the normal tissue biodistribution of radiolabeled FAPI in comparison to [ 18 F]F-FDG, all the included studies showed a lower radiolabeled FAPI uptake in the normal brain, liver, and oral mucosa, compared to [ 18 F]F-FDG [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…No additional studies were found screening the references of the selected articles. Finally, 26 articles (925 patients) including data on the comparison between radiolabeled FAPI and [ 18 F]F-FDG as PET radiotracers in oncology were included in the systematic review [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. The characteristics of the studies selected for the systematic review are presented in Table 1 , Table 2 , Table 3 .…”

Section: Resultsmentioning

confidence: 99%

“…Through the comprehensive computer literature search, 26 full-text articles including data on the head-to-head comparison of radiolabeled FAPI and [ 18 F]F-FDG in cancer patients were selected ( Table 1 ) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. All the selected articles were published in the last two years.…”

Section: Resultsmentioning

confidence: 99%

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Head-to-Head Comparison of Fibroblast Activation Protein Inhibitors (FAPI) Radiotracers versus [18F]F-FDG in Oncology: A Systematic Review

Treglia

Muoio

Roustaei

et al. 2021

IJMS

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Several recent studies comparing radiolabeled fibroblast activation protein inhibitors (FAPI) and fluorine-18 fluorodeoxyglucose ([18F]F-FDG) as positron emission tomography (PET) radiotracers in oncology have been published. The aim of this systematic review is to perform an updated evidence-based summary about the comparison of these PET radiotracers in oncology to better address further research in this setting. Studies or subsets of studies comparing radiolabeled FAPI and [18F]F-FDG as PET radiotracers in oncology were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until August 2021. Literature data about the comparison of [18F]F-FDG and radiolabeled FAPI are rapidly increasing. Overall, taking into account radiotracer uptake and tumor-to-background uptake ratio, compared to [18F]F-FDG PET, an equal or higher detection of primary tumors and/or metastatic lesions was usually demonstrated by using radiolabeled FAPI PET. In particular, the cancer entities with better detection rate of tumor lesions by using radiolabeled FAPI PET, compared to [18F]F-FDG PET, were gastrointestinal tumors, liver tumors, breast cancer and nasopharyngeal carcinoma. Further comparison studies are needed to better evaluate the best field of application of radiolabeled FAPI PET.

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“…In 12/23 studies [ 68 Ga]Ga-FAPI was offered as a compassionate drug according to the German Medicinal Product Act § 13(2b) [25,26,35,36,[27][28][29][30][31][32][33][34]. In the remaining 10/23 papers, the trial phase was not speci ed or designated as "not applicable" [37][38][39][40][41][42][43][44][45][46]. In 18/23 studies [ 68 Ga]Ga-FAPI imaging was compared to other imaging technique(s).…”

Section: Systematic Reviewmentioning

confidence: 99%

State-of-the-art of FAPI-PET imaging: a systematic review and meta-analysis

Sollini

Kirienko

Gelardi

et al. 2021

Eur J Nucl Med Mol Imaging

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Introduction Fibroblast Activation Protein-α (FAPα) is overexpressed on cancer-associated broblasts in approximately 90% of epithelial neoplasms, representing an appealing target for therapeutic and molecular imaging applications. [ 68 Ga]Ga-labelled radiopharmaceuticals-FAP-inhibitors (FAPI) -have been developed for PET. We systematically reviewed and meta-analysed published literature to provide an overview of its clinical role.Materials and Methods The search, limited to January 1 st , 2018 -March 31 st 2021, was performed on MedLine and Embase databases using all the possible combinations of terms "FAP", FAPI", "PET/CT", "positron emission tomography", " broblast", "cancer-associated broblasts", "CAF", "molecular imaging", and " broblast imaging". Study quality was assessed using the QUADAS-2 criteria. Patient-based and lesion-based pooled sensitivities/speci cities of FAPI PET were computed using a random-effects model directly from the STATA "metaprop" command. Between-study statistical heterogeneity was tested (I 2statistics).Results Twenty-three studies were selected for systematic review. Investigations on staging or restaging head and neck cancer (n=2, 29 patients), abdominal malignancies (n=6, 171 patients), various cancers (n=2, 143 patients), and radiation treatment planning (n=4, 56 patients) were included in the metanalysis. On patient-based analysis, pooled sensitivity was 0.99 (95% CI 0.97-1.00) with negligible heterogeneity; pooled speci city was 0.87 (95% CI 0.62-1.00), with negligible heterogeneity. On lesion-based analysis, sensitivity and speci city had high heterogeneity (I 2 =88.56% and I 2 =97.20%, respectively). Pooled sensitivity for the primary tumour was 1.00 (95% CI 0.98-1.00) with negligible heterogeneity. Pooled sensitivity/speci city of nodal metastases had high heterogeneity (I 2 =89.18% and I 2 =95.74%, respectively). Pooled sensitivity in distant metastases was good (0.93 with 95% CI 0.88-0.97) with negligible heterogeneity.Conclusions FAPI-PET appears promising, especially in imaging cancers unsuitable for [ 18 F]FDG imaging, particularly primary lesions and distant metastases.However, high-level evidence is needed to de ne its' role, speci cally to identify cancer types, non-oncological diseases and clinical settings for its' applications.

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68Ga-fibroblast activation protein inhibitor PET/CT on gross tumour volume delineation for radiotherapy planning of oesophageal cancer

Cited by 39 publications

References 37 publications

FAP and FAPI-PET/CT in Malignant and Non-Malignant Diseases: A Perfect Symbiosis?

FAP and FAPI-PET/CT in Malignant and Non-Malignant Diseases: A Perfect Symbiosis?

Head-to-Head Comparison of Fibroblast Activation Protein Inhibitors (FAPI) Radiotracers versus [18F]F-FDG in Oncology: A Systematic Review

State-of-the-art of FAPI-PET imaging: a systematic review and meta-analysis

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