[68Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of gastric cancer: comparison with [18F]FDG PET/CT

Lin, Rong; Lin, Zefang; Chen, Zhenying; Zheng, Shusen; Zhang, Jiaying; Zang, Jie; Miao, Weibing

doi:10.1007/s00259-022-05799-5

Cited by 50 publications

(76 citation statements)

References 38 publications

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“…At present, there are few reports on the detection rate of [ 68 Ga]Ga-FAPI-04 PET in distant metastasis of gastric cancer. Among the five comparative studies, two compared the detection rates of [ 68 Ga]Ga-FAPI-04 PET and [ 18 F]-FDG PET in patients with gastric cancer with ovarian, liver and bone metastases, and found no significant difference [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Second, the detection methods are not unified. PET CT was used in three articles [ 9 , 11 , 12 ], while PET MRI and PET CT were used in two articles [ 10 , 13 ]. Finally, due to the low sample size and limited histopathological types of gastric cancer, it is impossible to compare the detection rates of [ 68 Ga]Ga-FAPI-04 PET MRI/CT and [ 18 F]-FDG PET MRI/CT according to pathological classification.…”

Section: Discussionmentioning

confidence: 99%

“…This is the first systematic review and meta-analysis of all relevant comparative studies to compare the detection rates of [ 68 Ga]Ga-FAPI-04 PET MRI/CT and [ 18 F]-FDG PET MRI/CT in gastric cancer. This study included 148 participants from five independent comparative trials [9][10][11][12][13]. All participants had pathologically proven gastric cancer and received [ 68 Ga]Ga-FAPI-04 PET MRI/CT F]-FDG PET in gastric cancer with tumor size less than 30 mm was 16.8%, and that in early gastric cancer was 25.9% [14].…”

Section: Discussionmentioning

confidence: 99%

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[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

Wang

Luo

2023

Eur J Med Res

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Objectives To compare the detection rates of [68Ga]Ga-FAPI-04 PET MRI/CT vs. [18F]-FDG PET MRI/CT in gastric cancer. Methods An extensive librarian-led literature search of PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov was performed. The primary outcomes were sensitivity in patient-based evaluations, detection of lymph node metastases, and peritoneal involvement. Results Five studies, including 148 participants, were analyzed. [68Ga]Ga-FAPI-04 PET MRI/CT has a comparatively high sensitivity in patient-based evaluations compared with [18F]-FDG PET MRI/CT (risk difference = 0.16, 95% CI 0.09–0.22, P < 0.00001). The [68Ga]Ga-FAPI-04 PET MRI/CT group has a comparatively higher sensitivity in detecting lymph node metastases (RR = 0.15, 95% CI 0.01–0.29, P = 0.04), peritoneal involvement (RR = 0.55, 95% CI 0.38–0.72, P < 0.00001) in gastric cancer than [18F]-FDG PET MRI/CT group. Conclusions This systematic review confirmed the advantage of [68Ga]Ga-FAPI-04 PET MRI/CT in gastric cancer. [68Ga]Ga-FAPI-04 PET MRI/CT was superior to [18F]-FDG PET MRI/CT in detecting the primary tumor, lymph node metastases, and peritoneal metastases. More studies are needed for the sensitivity and specificity of [68Ga]Ga-FAPI-04 PET MRI/CT in different pathological types of gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

Wang

Luo

2023

Eur J Med Res

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“…In recent years, a variety of quinoline-based FAP inhibitors (FAPIs) have been developed, such as FAPI-02, FAPI-04 and FAPI-46 2 , 3 . FAPI PET/CT demonstrated advantages over 2-[ 18 F]FDG PET/CT for the diagnosis of primary and metastatic lesions of various types of cancer, in terms of uptake, sensitivity, favorable imaging contrast, and ultimately higher tumor detection rate 4 , 5 . While FAPI grants a wider spectrum of tumor targeting potential compared to conventional radiotracers that recognize tumor cell-specific biomarkers, for example somatostatin receptor subtype-2 targeting DOTATATE and prostate specific membrane antigen targeting PSMA-617; it can be a double-edged sword.…”

Section: Introductionmentioning

confidence: 99%

Synthesis, preclinical evaluation and radiation dosimetry of a dual targeting PET tracer [⁶⁸Ga]Ga-FAPI-RGD

Zang¹,

Wen²,

Lin³

et al. 2022

Theranostics

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To enhance tumor uptake and retention, we designed and developed bi-specific heterodimeric radiotracers targeting both FAP and αvβ3, [ 68 Ga]Ga-FAPI-RGD. The present study aimed to evaluate the specificity, pharmacokinetics, and dosimetry of [ 68 Ga]Ga-FAPI-RGD by preclinical and preliminary clinical studies. Methods: FAPI-RGD was designed and synthesized with the quinoline-based FAPI-02 and the cyclic RGDfK peptide. Preclinical pharmacokinetics were determined in Panc02 xenograft model using microPET and biodistribution experiments. The safety and effective dosimetry of [ 68 Ga]Ga-FAPI-RGD was evaluated in 6 cancer patients, and compared with 2-[ 18 F]FDG imaging. Results: The [ 68 Ga]Ga-FAPI-RGD had good stability in saline for at least 4 h, and showed favorable binding affinity and specificity in vitro and in vivo . Compared to [ 68 Ga]Ga-FAPI-02 and [ 68 Ga]Ga-RGDfK, the tumor uptake and retention of [ 68 Ga]Ga-FAPI-RGD were very much enhanced than its monomeric counterparts at all the time points examined by microPET imaging. A total of 6 patients with various malignant tumors were prospectively enrolled. The effective dose of [ 68 Ga]Ga-FAPI-RGD was 1.94E-02 mSv/MBq. The biodistribution of [ 68 Ga]Ga-FAPI-RGD from 0 to 2 h after injection demonstrated rapid and high tumor uptake, prolonged tumor retention, and high tumor-to-background ratios (TBRs) which further increased over time. No significant difference in mean SUVmax of [ 68 Ga]Ga-FAPI-RGD and 2-[ 18 F]FDG was present in primary tumors (8.9±3.2 vs. 10.3 ± 6.9; p = 0.459). Conclusion: The dual targeting PET tracer [ 68 Ga]Ga-FAPI-RGD showed significantly improved tumor uptake and retention, as well as cleaner background over 68 Ga-labeled FAPI and RGD monospecific tracers. The first-in-human biodistribution study showed high TBRs over time, suggesting high diagnostic performance and favorable tracer kinetics for potential therapeutic applications.

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“…Recently, fibroblast activation protein (FAP) targeted 68 Ga-FAPI-04 PET/CT imaging has shown overwhelming superiority compared with ¹⁸F-FDG PET/CT imaging in diagnosing primary tumors, lymph node metastasis, and peritoneal carcinomatosis in gastrointestinal cancer patients [9][10][11][12][13][14][15][16][17][18]. Based on previous studies, we hypothesized that 68 Ga-FAPI-04 PET imaging might be superior in detecting anastomotic recurrence compared to ¹⁸F-FDG PET imaging, since low FAP expression on macrophages, which are the primary inflammatory cells avid to ¹⁸F-FDG [19].…”

Section: Introductionmentioning

confidence: 99%

68Ga-FAPI-04 PET for surveillance of anastomotic recurrence in postoperative patients with gastrointestinal cancer: a comparative study with 18F-FDG PET

Wang

et al. 2022

Preprint

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Purpose: 68Ga-FAPI-04 PET imaging has shown clinical advantages for detecting and staging various solid tumor types, including gastrointestinal cancer. This study aims to compare the diagnostic efficacy of 68Ga-FAPI-04 PET and 18F-FDG PET for detecting anastomotic recurrence in postoperative patients with gastrointestinal cancer and to characterize the pattern of 68Ga-FAPI-04 uptake at surgical wounds post-surgery. Methods: This study involved 63 gastrointestinal cancer patients who underwent 68Ga-FAPI-04 and 18F-FDG PET/CT imaging, or 68Ga-FAPI-04 PET/CT imaging only for postoperative surveillance after curative surgical resection. The SUVmax at surgical wounds (anastomotic sites and abdominal incision sites) and its corresponding ratio compared to background were assessed. Endoscopic pathology confirmed anastomotic recurrence or it was ruled out by imaging and clinical follow-up. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of the two PET imaging in detecting anastomotic recurrence were compared based on the analysis of paired FAPI-FDG PET imaging. Relationships between tracer uptake at surgical wounds and postoperative time were also analyzed. Results: Sensitivity, specificity, PPV, NPV, and accuracy of detecting anastomotic recurrence were 100.0%, 87.3%, 41.7%, 100.0%, and 88.3% for 68Ga-FAPI-04 PET imaging, and 60.0%, 81.8%, 23.1%, 95.7%, and 80.0% for 18F-FDG PET imaging respectively. Compared with non-recurrent patients, the recurrent patients exhibited a significantly higher anastomotic SUVmax and ratio on FAPI-PET imaging (SUVmax : 9.92±4.36 vs. 2.81±1.86, P =0.002; Ratio: 5.11±1.99 vs. 2.23±1.17, P <0.001). 68Ga-FAPI-04 PET displayed a significantly higher SUVmax ratio at surgical wounds than 18F-FDG PET imaging (anastomotic sites: 2.57±1.61 vs. 1.76±0.74, P =0.001; abdominal incision sites: 2.14±1.47 vs. 1.65±1.12, P =0.029). Although 68Ga-FAPI-04 PET signal at surgical wounds showed a slight trend to decrease over time (anastomotic SUVmax : r=-0.2830, P =0.0223; incisional SUVmax : r=-0.4549, P <0.0001), no statistical difference was observed over months post-surgery ( P >0.05). Conclusion: The surveillance power of 68Ga-FAPI-04 PET is superior to 18F-FDG PET in postoperative anastomotic recurrence of gastrointestinal cancer, but the positive predictive value was limited due to wound healing inference. Therefore, combined surveillance methods were suggested instead of relying on 68Ga-FAPI-04 or 18F-FDG PET only.

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[68Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of gastric cancer: comparison with [18F]FDG PET/CT

Cited by 50 publications

References 38 publications

[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

Synthesis, preclinical evaluation and radiation dosimetry of a dual targeting PET tracer [⁶⁸Ga]Ga-FAPI-RGD

68Ga-FAPI-04 PET for surveillance of anastomotic recurrence in postoperative patients with gastrointestinal cancer: a comparative study with 18F-FDG PET

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[68Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of gastric cancer: comparison with [18F]FDG PET/CT

Cited by 50 publications

References 38 publications

[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

[68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis

Synthesis, preclinical evaluation and radiation dosimetry of a dual targeting PET tracer [68Ga]Ga-FAPI-RGD

68Ga-FAPI-04 PET for surveillance of anastomotic recurrence in postoperative patients with gastrointestinal cancer: a comparative study with 18F-FDG PET

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Synthesis, preclinical evaluation and radiation dosimetry of a dual targeting PET tracer [⁶⁸Ga]Ga-FAPI-RGD