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Clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma

Clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron... PurposeThis study aimed to explore the clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor ([68Ga]Ga-FAPI) positron emission tomography/computed tomography (PET/CT) relative to [18F]-fluorodeoxyglucose ([18F]FDG) PET/CT and magnetic resonance imaging (MRI) for primary staging and recurrence detection in nasopharyngeal carcinoma (NPC).MethodsThis retrospective analysis utilized a sub-cohort of patients from a previously acquired database. Patients with NPC who underwent [18F]FDG and [68Ga]Ga-FAPI PET/CT between October 2019 and November 2020 were included. The radiotracer uptake and clinical staging/restaging performances of [18F]FDG and [68Ga]Ga-FAPI PET/CT were compared.ResultsForty-five participants (39 for initial assessment, 6 for recurrence detection) were included. In treatment-naïve participants, [68Ga]Ga-FAPI PET/CT showed higher radiotracer uptake than [18F]FDG PET/CT in primary tumors (16.18 vs. 10.11, P < 0.001), regional lymph nodes (11.42 vs. 7.37, P < 0.001), and bone and visceral metastases (6.94 vs. 3.11, P < 0.001). Compared with the [18F]FDG-based TNM stage, the [68Ga]Ga-FAPI-based TNM stage was upgraded in ten patients (26%), resulting in management changes in seven patients (18%). Compared with MRI, [68Ga]Ga-FAPI PET/CT upgraded and underestimated the T stage in four and two patients, respectively. In post-treatment patients, [68Ga]Ga-FAPI PET/CT yielded more true-positive findings than [18F]FDG PET/CT in detecting local recurrence.Conclusion[68Ga]Ga-FAPI PET/CT is a promising imaging modality for the diagnosis of primary and metastatic NPC. The exact tumor geographic imaging obtained through [68Ga]Ga-FAPI PET/CT may be a supplement to MRI for T staging and radiotherapy planning. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Nuclear Medicine and Molecular Imaging Springer Journals

Clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma

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References (41)

Publisher
Springer Journals
Copyright
Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021
ISSN
1619-7070
eISSN
1619-7089
DOI
10.1007/s00259-021-05336-w
Publisher site
See Article on Publisher Site

Abstract

PurposeThis study aimed to explore the clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor ([68Ga]Ga-FAPI) positron emission tomography/computed tomography (PET/CT) relative to [18F]-fluorodeoxyglucose ([18F]FDG) PET/CT and magnetic resonance imaging (MRI) for primary staging and recurrence detection in nasopharyngeal carcinoma (NPC).MethodsThis retrospective analysis utilized a sub-cohort of patients from a previously acquired database. Patients with NPC who underwent [18F]FDG and [68Ga]Ga-FAPI PET/CT between October 2019 and November 2020 were included. The radiotracer uptake and clinical staging/restaging performances of [18F]FDG and [68Ga]Ga-FAPI PET/CT were compared.ResultsForty-five participants (39 for initial assessment, 6 for recurrence detection) were included. In treatment-naïve participants, [68Ga]Ga-FAPI PET/CT showed higher radiotracer uptake than [18F]FDG PET/CT in primary tumors (16.18 vs. 10.11, P < 0.001), regional lymph nodes (11.42 vs. 7.37, P < 0.001), and bone and visceral metastases (6.94 vs. 3.11, P < 0.001). Compared with the [18F]FDG-based TNM stage, the [68Ga]Ga-FAPI-based TNM stage was upgraded in ten patients (26%), resulting in management changes in seven patients (18%). Compared with MRI, [68Ga]Ga-FAPI PET/CT upgraded and underestimated the T stage in four and two patients, respectively. In post-treatment patients, [68Ga]Ga-FAPI PET/CT yielded more true-positive findings than [18F]FDG PET/CT in detecting local recurrence.Conclusion[68Ga]Ga-FAPI PET/CT is a promising imaging modality for the diagnosis of primary and metastatic NPC. The exact tumor geographic imaging obtained through [68Ga]Ga-FAPI PET/CT may be a supplement to MRI for T staging and radiotherapy planning.

Journal

European Journal of Nuclear Medicine and Molecular Imaging – Springer Journals

Published: Oct 1, 2021

Keywords: [68Ga]Ga-labeled fibroblast activation protein inhibitor; [18F]-Fluorodeoxyglucose; Positron emission tomography/computed tomography; Magnetic resonance imaging; Nasopharyngeal carcinoma

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