A Head-to-Head Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/MR in Patients with Nasopharyngeal Carcinoma: A Prospective Study

Qin, Chunxia; Liu, Fang; Huang, Jing; Gai, Yongkang; Liu, Qingyao; Ruan, Weiwei; Yang, Kunyu; Lan, Xiaoli

doi:10.21203/rs.3.rs-252484/v1

Cited by 5 publications

(6 citation statements)

References 23 publications

(77 reference statements)

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“…Recent studies with head-to-head comparison of 18 F-FDG and 68 Ga-FAPI PET/CT showed a tendency toward upstaging after 68 Ga-FAPI PET/CT in various types of cancer, including esophageal cancer, 1 lung cancer, 2 liver cancer, 3 pancreatic cancer, 4 gastric cancer, 5,6 and NPC. 7,8 However, in this case, 68 Ga-FAPI PET/CT led to downstaging of NPC compared with 18 F-FDG PET/CT and MRI. The nonmetastatic reactive lymph nodes, presented false-positive uptake of 18 F-FDG, were correctly diagnosed by 68 Ga-FAPI PET/CT.…”

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confidence: 70%

68Ga-FAPI PET/CT Distinguishes the Reactive Lymph Nodes From Tumor Metastatic Lymph Nodes in a Patient With Nasopharyngeal Carcinoma

et al. 2021

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Accurate clinical staging is crucial for managing nasopharyngeal carcinoma (NPC). However, false-positive finding of cervical lymph nodes in 18 F-FDG PET/CT and MRI may lead to unnecessary chemotherapy for NPC. In this case, we report a patient with NPC who was incorrectly diagnosed with bilateral cervical lymph node metastases by both 18 F-FDG PET/CT and MRI. Subsequent pathology results showed proliferating lymphoid cells with no signs of tumor metastasis. Interestingly, no abnormal 68 Ga-FAPI uptake was observed in the nonmetastatic reactive lymph nodes. Therefore, 68 Ga-FAPI PET/CT may be useful for assessment of pretreatment lymph node status in NPC.

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confidence: 70%

68Ga-FAPI PET/CT Distinguishes the Reactive Lymph Nodes From Tumor Metastatic Lymph Nodes in a Patient With Nasopharyngeal Carcinoma

et al. 2021

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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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“…Lastly, 68 Ga-FAPI can also be coupled with PET/MR to achieve similar results to PET/ CT based imaging. This is particularly valuable for NPC patients with suspected distant metastasis as 68 Ga-FAPI PET/MR could serve as a single-step staging modality [83].…”

Section: Ga-fapi Imagingmentioning

confidence: 99%

Advances in nuclear medicine-based molecular imaging in head and neck squamous cell carcinoma

Zhao

et al. 2022

J Transl Med

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Head and neck squamous cell carcinomas (HNSCCs) are often aggressive, making advanced disease very difficult to treat using contemporary modalities, such as surgery, radiation therapy, and chemotherapy. However, targeted therapy, e.g., cetuximab, an epidermal growth factor receptor inhibitor, has demonstrated survival benefit in HNSCC patients with locoregional failure or distant metastasis. Molecular imaging aims at various biomarkers used in targeted therapy, and nuclear medicine-based molecular imaging is a real-time and non-invasive modality with the potential to identify tumor in an earlier and more treatable stage, before anatomic-based imaging reveals diseases. The objective of this comprehensive review is to summarize recent advances in nuclear medicine-based molecular imaging for HNSCC focusing on several commonly radiolabeled biomarkers. The preclinical and clinical applications of these candidate imaging strategies are divided into three categories: those targeting tumor cells, tumor microenvironment, and tumor angiogenesis. This review endeavors to expand the knowledge of molecular biology of HNSCC and help realizing diagnostic potential of molecular imaging in clinical nuclear medicine.

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A Head-to-Head Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/MR in Patients with Nasopharyngeal Carcinoma: A Prospective Study

Cited by 5 publications

References 23 publications

68Ga-FAPI PET/CT Distinguishes the Reactive Lymph Nodes From Tumor Metastatic Lymph Nodes in a Patient With Nasopharyngeal Carcinoma

68Ga-FAPI PET/CT Distinguishes the Reactive Lymph Nodes From Tumor Metastatic Lymph Nodes in a Patient With Nasopharyngeal Carcinoma

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

Advances in nuclear medicine-based molecular imaging in head and neck squamous cell carcinoma

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