Comparison of PET imaging of activated fibroblasts and 18F-FDG for diagnosis of primary hepatic tumours: a prospective pilot study

Shi, Ximin; Xing, Haiqun; Yang, Xiaobo; Li, Fang; Yao, Shaobo; Jia, Congwei; Zhao, Haitao; Hacker, Marcus; Huo, Li; Li, Xiang

doi:10.1007/s00259-020-05070-9

Cited by 97 publications

(123 citation statements)

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“…Recently, 68 Ga-labelled FAPI was shown to be a novel tracer in PET/CT imaging of various cancers due to its high tumour-tobackground contrast (17,27). Furthermore, 68 Ga-FAPI-04 PET/ CT has high sensitivity in detecting hepatic malignancies, including HCC and ICC (19,21).…”

Section: Discussionmentioning

confidence: 99%

“…Recent investigations indicated that 68 Ga-labelled FAP inhibitor (FAPI) shows an equal or even improved tumour imaging with lower background uptake in the liver and the brain in comparison to 18 F-FDG in various cancers (17,18). 68 Ga-FAPI-04 PET/CT was also revealed to have high sensitivity in detecting hepatic malignancies (19)(20)(21). Therefore,…”

Section: Introductionmentioning

confidence: 99%

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68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

et al. 2021

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BackgroundFibroblast activation protein (FAP) is commonly expressed in activated stromal fibroblasts in various epithelial tumours. Recently, 68Ga-FAPI-04 has been used for tumour imaging in positron emission tomography/computed tomography (PET/CT). This study aimed to compare the diagnostic performances of 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in hepatocellular carcinoma (HCC), and to assess factors associated with 68Ga-FAPI-04 uptake in HCC.Materials and MethodsTwenty-nine patients with suspiciously HCC who received both 18F-FDG and 68Ga-FAPI-04 PET/CT were included in this retrospective study. The results were interpreted by two experienced nuclear medicine physicians independently. The maximum and mean standardized uptake values (SUVmax and SUVmean) were measured in the lesions and liver background, respectively. The tumour-to-background ratio (TBR) was then calculated as lesion’s SUVmax divided by background SUVmean.ResultsA total of 35 intrahepatic lesions in 25 patients with HCC were finally involved in the statistical analysis. 68Ga-FAPI-04 PET/CT showed a higher sensitivity than 18F-FDG PET/CT in detecting intrahepatic HCC lesions (85.7% vs. 57.1%, P = 0.002), including in small (≤ 2 cm in diameter; 68.8% vs. 18.8%, P = 0.008) and well- or moderately-differentiated (83.3% vs. 33.3%, P = 0.031) tumors. SUVmax was comparable between 68Ga-FAPI-04 and 18F-FDG (6.96 ± 5.01 vs. 5.89 ± 3.38, P > 0.05), but the TBR was significantly higher in the 68Ga-FAPI-04 group compared with the 18F-FDG group (11.90 ± 8.35 vs. 3.14 ± 1.59, P < 0.001). SUVmax and the TBR in 68Ga-FAPI-04 positive lesions were associated with tumour size (both P < 0.05), but not the remaining clinical and pathological features (all P > 0.05).Conclusions68Ga-FAPI-04 PET/CT is more sensitive than 18F-FDG PET/CT in detecting HCC lesions, and 68Ga-FAPI-04 uptake is correlated mainly with tumour size.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

et al. 2021

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“…Any difference of opinion between these two physicians was resolved by a consensus. For primary tumors and metastatic lesions, positive uptake was identi ed as areas of focal increase compared to surrounding normal tissue by a visual assessment supported by the ratio of suspicious lesions to surrounding normal tissue [16,26].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 68Ga-FAPI-04 and 18F-FDG for the Detection of Primary Gastric Cancers and Metastasis 

Jiang

Chen

Zhang

et al. 2021

Preprint

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Introduction Early and precise diagnosis and staging of gastric cancer are important for its treatment and management. However, the low sensitivity of 18F-fluorodeoxyglucose (18F-FDG) for gastric cancer diagnosis limits its application. Currently, the tracer 68Ga-FAPI, which targets fibroblast activation protein (FAP), is widely used to diagnose various cancers. However, the diagnostic value of 68Ga-FAPI in gastric cancer is still unclear. In this study, we aimed to investigate the potential advantage of 68Ga-FAPI-04 over 18F-FDG in the evaluation of gastric cancer.Methods: Thirty-eight patients with gastric cancer (31 with adenocarcinoma and 7 with signet ring cell carcinoma) were recruited for this study. All of the participants underwent 68Ga-FAPI-04 and 18F-FDG imaging by positron emission tomography (PET)/computed tomography (CT) or PET/magnetic resonance (MR). The results were interpreted by two experienced nuclear medicine physicians, and the maximum standardized uptake value (SUVmax) was calculated.Results: For the detection of primary gastric cancer, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET were 100% (38/38) and 81.6% (31/38), respectively. Four cases of adenocarcinoma and three cases of signet ring cell carcinoma were missed by 18F-FDG PET. The SUVmax of 68Ga-FAPI-04 in tumors greater than 4 cm (11.0 ± 4.5) was higher than tumors less than 4 cm (4.5 ± 3.2) (P = 0.0015). The SUVmax of 68Ga-FAPI-04 was higher in T2-4 tumors (9.7 ± 4.4) than in T1 tumors (3.1 ± 1.5) (P = 0.0002). For the detection of metastatic lesions, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET in 10 patients with regional lymph node metastasis and distant metastasis were 6/10 and 5/10, respectively.Conclusion: Compared to 18F-FDG PET, 68Ga-FAPI-04 PET had superior potential in detecting primary gastric cancers and metastatic lymph nodes, 68Ga-FAPI-04 PET also had a better performance on small gastric cancer detection. 68Ga-FAPI-04 PET could provide better performance for gastric cancer diagnosis and staging.

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“…Furthermore, compared to[ 18 F]FDG, the lower hepatic background of [ 68 Ga]Ga-DOTA-FAPI-04 may be a promising feature for evaluation of liver metastases(Fig. 1) as Shi et al [20] research reported.…”

Section: Discussionmentioning

confidence: 92%

Comparison of [68Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosis of metastasis in differentiated thyroid cancer with negative iodine scintigraphy

Wu¹,

Liao²,

Huang³

et al. 2021

Preprint

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Purpose Evaluation of the potential value of [68Ga]Ga-DOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) and [18F]FDG PET/CT in detection of differentiated thyroid cancer (DTC) metastases. Methods [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT scans were performed on suspected metastatic DTC patients. Maximum standard uptake value (SUVmax) was used to quantify the uptake of positive lesions. Histopathology or follow-up images were used as the standard for final diagnosis.Results A total of 35 DTC patients underwent [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT scans in the same time period. Average SUVmax of [68Ga]Ga-DOTA-FAPI-04 uptake by DTC lesions was low (average SUVmax<7). The difference in detection rate of SUVmax of[68Ga]Ga-DOTA-FAPI-04compared with that of[18F]FDG in bone metastases was statistically significant (P=0.000, 0.049). There were differences in the detection rate of other distant and lymph node metastases, and SUVmax, with no statistical significance (P>0.05). The specificity, accuracy, and positive predictive value of [68Ga]Ga-DOTA-FAPI-04 in the diagnosis of lymph node lesions were higher than those of [18F]FDG PET/CT, and the difference was statistically significant (c2=16.583，c2=9.910，c2=7.548，c2=2.781, P＜0.05). There were no statistically significant differences in sensitivity, specificity, accuracy, and positive and negative predictive value of the two groups in the diagnosis of distant metastases (c2=0.440，c2=4.956，c2=0.013，c2=1.194，c2=2.618，P＞0.05). Conclusion [68Ga]Ga-DOTA-FAPI-04 has certain advantages over [18F]FDG PET/CT in detecting lymph node and bone metastases. It has the same ability to detect other distant metastases and can be used as a supplementary imaging method for DTC.

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Comparison of PET imaging of activated fibroblasts and 18F-FDG for diagnosis of primary hepatic tumours: a prospective pilot study

Cited by 97 publications

References 32 publications

68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

Comparison of 68Ga-FAPI-04 and 18F-FDG for the Detection of Primary Gastric Cancers and Metastasis

Comparison of [68Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosis of metastasis in differentiated thyroid cancer with negative iodine scintigraphy

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Comparison of PET imaging of activated fibroblasts and 18F-FDG for diagnosis of primary hepatic tumours: a prospective pilot study

Cited by 97 publications

References 32 publications

68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

68Ga-FAPI-04 Versus 18F-FDG PET/CT in the Detection of Hepatocellular Carcinoma

Comparison of 68Ga-FAPI-04 and 18F-FDG&nbsp;for the Detection of Primary Gastric Cancers and Metastasis&nbsp;

Comparison of [68Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosis of metastasis in differentiated thyroid cancer with negative iodine scintigraphy

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Comparison of 68Ga-FAPI-04 and 18F-FDG for the Detection of Primary Gastric Cancers and Metastasis