Benign Bone Cyst Mimicking Bone Metastasis Demonstrated on 68Ga-FAPI

Güngör, Serkan; Selçuk, Nalan Alan

doi:10.1097/rlu.0000000000003796

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…In light of our present findings, however, somewhat heightened caution is needed for such endeavors. For treatment with FAPIs, side effects associated with tracer accumulation in normal tissues or benign lesions may present a major issue, as benign lesions including pulmonary fibrosis, which showed increased FAPI uptake, are common ( 32 , 33 ). Additionally, many patients with primary lung cancers or other intrathoracic malignancies undergo adjuvant radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of 18F-NOTA-FAPI PET/CT in a Rat Model of Radiation-Induced Lung Damage

et al. 2022

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In this study, we explore the diagnostic value of a novel PET/CT imaging tracer that specifically targets fibroblast activation protein (FAP), 18F-NOTA-FAPI, in a radiation induced lung damage (RILD) rat model. High focal radiation (40, 60, or 90 Gy) was administered to a 5-mm diameter area of the right lung in Wistar rats for evaluation of RILD induction. Lung tissues exposed to 90 Gy radiation were scanned with 18F-NOTA-FAPI PET/CT and with 18F-FDG. Dynamic 18F-NOTA-FAPI PET/CT scanning was performed on day 42 post-irradiation. After in vivo scanning, lung cryosections were prepared for autoradiography, hematoxylin and eosin (HE) and immunohistochemical (IHC) staining. An animal model of RILD was established and validated by histopathological analysis. On 18F-NOTA-FAPI PET/CT, RILD was first observed on days 42, 35 and 7 in the 40, 60 and 90 Gy groups, respectively. After treatment with 90 Gy, 18F-NOTA-FAPI uptake in an area of RILD emerged on day 7 (0.65 ± 0.05%ID/ml) and reappeared on day 28 (0.81 ± 0.09%ID/ml), remaining stable for 4–6 weeks. Autoradiography and HE staining IHC staining revealed that 18F-NOTA-FAPI accumulated mainly in the center of the irradiated area. IHC staining confirmed the presence of FAP+ macrophages in the RILD area, while FAP+ fibroblasts were observed in the peripheral area of irradiated lung tissue. 18F-NOTA-FAPI represents a promising radiotracer for in vivo imaging of RILD in a dose- and time-dependent manner. Noninvasive imaging of FAP may potentially aiding in the clinical management of radiotherapy patients.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of 18F-NOTA-FAPI PET/CT in a Rat Model of Radiation-Induced Lung Damage

et al. 2022

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“…6,29,32 Because 68 Ga-FAPI-04 PET/CT might not show the typical bull's-head sign seen in a whole-body bone scan, this reduces its diagnostic specificity. Moreover, some studies showed 18 F-FDG could be used to distinguish active from inactive inflammatory lesions in SAPHO syndrome. 33-36 18 F-FDG PET/CT was not included in this study as it is not routinely used for this disease in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…However, FAP expression is not cancer-specific; it is overexpressed in tissue remodeling sites associated with inflammation, fibrosis, rheumatological diseases, atherosclerosis, and cardiac injury, among others 10,11 . 68 Ga-FAPI PET has shown good application prospects in imaging benign bone, joint, or muscle diseases, including immunoglobulin G4–related disease, 12,13 polymyositis, 14 rheumatoid arthritis, 15 osteoarthritis, 11,16,17 bone cyst, 18 fracture, 19 myositis ossificans, 20 Schmorl node, 21 osteofibrous dysplasia, 16,22 intraosseous meningioma, 23 and bone tuberculous 24 . The histopathological features of SAPHO syndrome are nonspecific osteomyelitis with inflammatory cell infiltration and a healing process with osteosclerosis and bone marrow fibrosis 4,25,26 .…”

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confidence: 99%

Prospective Comparison of the Imaging Value of 99mTc-MDP Bone Scan and 68Ga-FAPI-04 PET/CT in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome

Ding

Fan

et al. 2023

Clin Nucl Med

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Purpose: This study aimed to explore the imaging value of 68 Ga-FAPI-04 PET/CT in synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome and compare it with that of 99m Tc-MDP bone scan. Methods: Nineteen participants with SAPHO syndrome underwent 68 Ga-FAPI-04 PET/CT and 99m Tc-MDP bone scan. Demographic data and clinical features were recorded, SAPHO imaging features were analyzed, and the osteoarticular lesion detection rate in both methods was calculated.Results: This prospective study recruited 4 men and 15 women aged 52.4 ± 8.6 years. The anterior chest wall was involved in all participants (100%). Palmoplantar pustulosis was the most common (36.8%) skin symptom. 99m Tc-MDP bone scan and 68 Ga-FAPI-04 PET/CT together detected 84 osteoarticular lesions, of which 91.7% (77/84) were detected by the former and 96.4% (81/84) by the latter. Furthermore, 68 Ga-FAPI-04 PET/CT detected 5 cases of knee and hip joint synovitis. Conclusions: 68 Ga-FAPI-04 PET/CT was more sensitive than 99m Tc-MDP bone scan when evaluating osteoarticular lesions in SAPHO syndrome and could also evaluate synovial lesions. 68 Ga-FAPI-04 PET/CT could be a good imaging method for SAPHO syndrome but requires further verification in a more extensive research cohort.

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“…[10][11][12] However, a recent study concerning 26 patients with SAPHO syndrome has shown a poor agreement between PET imaging and clinical symptoms 12 Recently, 68 Ga-DOTA-FAPI-04, which targets fibroblast activation protein (FAP), is introduced in tumor imaging. However, FAP was also shown to be expressed in many types of nonmalignant bone or joint pathologies including arthritis, 13 fracture, 14 benign bone cyst, 15 fibrous dysplasia, 16 myositis ossificans, 17 avascular necrosis of the bone, 18 Schmorl node, 19 ankylosing spondylitis, 20 bone tuberculosis, 21 and other types of bone infection. 22 Thus, we speculate that sites of SAPHO involvement might be imaged with 68 Ga-DOTA-FAPI-04.…”

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confidence: 99%

Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT in Patients With SAPHO Syndrome

Wang¹,

Li²,

Hou³

et al. 2023

Clin Nucl Med

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Purpose Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare inflammatory disorder of bone, joints, and skin, with various stages of bone lesions including inflammation and bone marrow fibrosis. Because the inflammation-induced fibrosis and bone marrow fibrosis are important features in SAPHO syndrome, we undertook a prospective investigation to evaluate whether PET/CT with 68Ga-DOTA-FAPI-04, a novel PET agent targeting fibroblast activation protein, was useful in the evaluation of the patients with SAPHO syndrome. Patients and Methods 68Ga-DOTA-FAPI-04 PET/CT was performed on a cohort of 21 patients with known SAPHO syndrome. All patients underwent 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT on 2 consecutive days. The positive rates of the PET/CT scans at the sites of the osteoarticular symptom, the uptake values, and agreement with clinical osteoarticular symptom were compared. Results A total of 38 sites of involvement were detected. 18F-FDG PET/CT revealed 28 lesions. In contrast, 68Ga-DOTA-FAPI-04 PET/CT detected not only all lesions shown on 18F-FDG PET/CT but additional 10 lesions. 68Ga-DOTA-FAPI-04 scan also demonstrated significantly higher uptake and target-to-background ratio than 18F-FDG studies in the skeletal involvements. The agreement between 68Ga-DOTA-FAPI-04–positive lesions and current osteoarticular lesions was substantial (κ = 0.79, P < 0.001), whereas 18F-FDG had low to moderate agreement with clinical symptoms (κ = 0.52, P < 0.001). Conclusions 68Ga-DOTA-FAPI-04 has potential as a promising imaging agent for the evaluation of SAPHO syndrome.

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Benign Bone Cyst Mimicking Bone Metastasis Demonstrated on 68Ga-FAPI

Cited by 9 publications

References 13 publications

Diagnostic Value of 18F-NOTA-FAPI PET/CT in a Rat Model of Radiation-Induced Lung Damage

Diagnostic Value of 18F-NOTA-FAPI PET/CT in a Rat Model of Radiation-Induced Lung Damage

Prospective Comparison of the Imaging Value of 99mTc-MDP Bone Scan and 68Ga-FAPI-04 PET/CT in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome

Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT in Patients With SAPHO Syndrome

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