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Wang B, Zhao X, Liu Y, Zhang Z, Chen X, Jing F, Chen X, Hua Y, Zhao J. Comparison of 68 Ga-FAPI-04 PET/CT with 18 F-FDG PET/CT for diagnosis and staging of gastric and colorectal cancer. Nucl Med Commun 2024; 45:612-621. [PMID: 38686487 DOI: 10.1097/mnm.0000000000001845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE The objective of this study is to evaluate the effectiveness of 68 Ga-FAPI-04 PET/computed tomography (CT) for the diagnosis of primary and metastatic gastric cancer and colorectal cancer lesions as compared with 18 F-FDG PET/CT. MATERIALS AND METHODS Fifty-nine patients who underwent both 18 F-FDG and 68 Ga-FAPI-04 for initial staging or restaging were enrolled. Histopathological findings and clinical imaging follow-up were used as the reference standard. The diagnostic performance and TNM staging of the two tracers were calculated and compared. The maximum standardized uptake value (SUV max ), tumour-to-mediastinal blood pool ratio (TBR) (lesions SUV max /ascending aorta SUV mean ), and tumour-to-normal liver parenchyma ratio (TLR) (lesions SUV max /liver SUV mean ) of primary and metastatic lesions between two imaging modalities were measured and compared using the Wilcoxon signed-rank test and paired t -test. RESULTS The two imaging agents are comparable for the detection of primary tumors. The sensitivity of 68 Ga-FAPI-04 PET/CT was higher than that of 18 F-FDG PET/CT for detecting lymph node metastases, peritoneal metastases, liver metastases, and bone metastases. In the patient-based analysis, the TLR for all lesions was significantly higher with 68 Ga-FAPI-04 PET/CT than with 18 F-FDG PET/CT (all P < 0.05). The accuracy (92.2 vs. 70.3%, P = 0.002) and sensitivity of 68 Ga-FAPI-04 were significantly higher than that of 18 F-FDG (78.6 vs. 71.4%, P = 0.011) in determining the lymph node status. 68 Ga-FAPI-04 has a higher accuracy in staging ( P = 0.041), which is mainly due to the ability of distant metastases detection. CONCLUSION 68 Ga-FAPI-04 PET/CT may be superior in evaluating the diagnostic efficiency and staging accuracy of gastric and colorectal cancer.
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Affiliation(s)
- Bin Wang
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Mo C, Zhang W, Zhu K, Du Y, Huang W, Wu Y, Song J. Advances in Injectable Hydrogels Based on Diverse Gelation Methods for Biomedical Imaging. SMALL METHODS 2024:e2400076. [PMID: 38470225 DOI: 10.1002/smtd.202400076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/01/2024] [Indexed: 03/13/2024]
Abstract
The injectable hydrogels can deliver the loads directly to the predetermined sites and form reservoirs to increase the enrichment and retention of the loads in the target areas. The preparation and injection of injectable hydrogels involve the sol-gel transformation of hydrogels, which is affected by factors such as temperature, ions, enzymes, light, mechanics (self-healing property), and pH. However, tracing the injection, degradation, and drug release from hydrogels based on different ways of gelation is a major concern. To solve this problem, contrast agents are introduced into injectable hydrogels, enabling the hydrogels to be imaged under techniques such as fluorescence imaging, photoacoustic imaging, magnetic resonance imaging, and radionuclide imaging. This review details methods for causing the gelation of imageable hydrogels; discusses the application of injectable hydrogels containing contrast agents in various imaging techniques, and finally explores the potential and challenges of imageable hydrogels based on different modes of gelation.
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Affiliation(s)
- Chunxiang Mo
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing, 10010, China
| | - Weiyao Zhang
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing, 10010, China
| | - Kang Zhu
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing, 10010, China
| | - Yang Du
- CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, Institute of Automation, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, 100190, China
| | - Wei Huang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Ying Wu
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing, 10010, China
| | - Jibin Song
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing, 10010, China
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Miao Y, Feng R, Yu T, Guo R, Zhang M, Wang Y, Hai W, Shangguan C, Zhu Z, Li B. Value of 68Ga-FAPI-04 and 18F-FDG PET/CT in Early Prediction of Pathologic Response to Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer. J Nucl Med 2024; 65:213-220. [PMID: 38164574 DOI: 10.2967/jnumed.123.266403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/07/2023] [Indexed: 01/03/2024] Open
Abstract
This prospective study investigated whether PET parameters from 18F-FDG and 68Ga-fibroblast activation protein inhibitor (FAPI)-04 PET/CT can predict a pathologic response to neoadjuvant chemotherapy (NAC) early in patients with locally advanced gastric cancer (LAGC). Methods: The study included 28 patients with LAGC who underwent 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT at baseline and after 1 cycle of NAC. PET parameters including SUV and tumor-to-background ratio (TBR), as well as the change rate of SUV and TBR, were recorded. Patients were classified as major or minor pathologic responders according to postoperative pathology findings. We compared the PET parameters between the 2 pathologic response groups and different treatment regimens and analyzed their predictive performance for tumor pathologic response. Results: Major pathologic responders had significantly lower 68Ga-FAPI change rates (percentage SUVmax [%SUVmax], percentage SUVpeak [%SUVpeak], and percentage TBR [%TBR]) than minor pathologic responders. Among the PET parameters, 68Ga-FAPI %SUVmax (area under the curve, 0.856; P = 0.009), %SUVpeak (area under the curve, 0.811; P = 0.022), and %TBR (area under the curve, 0.864; P = 0.007) were significant parameters for early prediction of pathologic response to NAC in LAGC; they had the same predictive accuracy of 89.29%, with the thresholds of decrease to at least 52.43%, 60.46%, and 52.96%, respectively. In addition, 68Ga-FAPI %SUVmax and %TBR showed significant differences between the different treatment regimens. Conclusion: In this preliminary study, 68Ga-FAPI-04 PET change rate parameters were preferable to 18F-FDG in predicting pathologic response to NAC at an early stage in LAGC. 68Ga-FAPI %SUVmax and %TBR may be better predictors of therapeutic response between different treatment regimens. These findings may help optimize the treatment for patients with LAGC.
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Affiliation(s)
- Ying Miao
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Runhua Feng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Teng Yu
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Guo
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Wang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wangxi Hai
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengfang Shangguan
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Zhenggang Zhu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, Shanghai, China
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Zhao Y, Ren J. 18F-FAPI-04 PET/CT parameters predict PD-L1 expression in esophageal squamous cell carcinoma. Front Immunol 2023; 14:1266843. [PMID: 38035081 PMCID: PMC10684668 DOI: 10.3389/fimmu.2023.1266843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose This prospective study examined whether metabolism parameters obtained using the tracer 18F-AlFNOTA-fibroblast activation protein inhibitor (FAPI)-04 (denoted as 18F-FAPI-04) in positron emission tomography/computed tomography (PET/CT) can predict programmed death ligand-1 (PD-L1) expression in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC). Patients and methods The 24 enrolled LA-ESCC patients underwent an 18F-FAPI-04 PET/CT scan. The maximum, mean, peak and standard deviation standard uptake values (SUVmax, SUVmean, SUVpeak and SUVsd), metabolic tumor volume (MTV), and total lesion FAP (TLF) expression of the primary tumor were collected. Additionally, we evaluated PD-L1 expression on cancer cells by immunohistochemistry and immunofluorescence methods. Patients were divided into negative and positive expressions according to the expression of PD-L1 (CPS < 10 and CPS ≥ 10), and the variables were compared between the two groups. Results The SUVmax, SUVmean, SUVpeak and SUVsd were significantly higher in patients with positive expression than in negative expression (all p < 0.05). Receiver operating characteristic curve analysis identified SUVmean (area under the curve [AUC] = 0.882, p = 0.004), SUVsd (AUC = 0.874, p = 0.005), SUVpeak (AUC = 0.840, p = 0.010) and SUVmax (AUC = 0.765, p = 0.045) as significant predictors of the PD-L1 positive expression, with cutoff values of 9.67, 1.90, 9.67 and 13.71, respectively. On univariate logistic regression analysis, SUVmean (p = 0.045), SUVsd (p = 0.024), and SUVpeak (p = 0.031) were significantly correlated with the PD-L1 positive expression. On multivariable logistic regression analysis, SUVsd (p = 0.035) was an optimum predictor factor for PD-L1 positive expression. Conclusion 18F-FAPI-04 PET/CT parameters, including SUVmean, SUVpeak, and SUVsd, correlated with PD-L1 expression in patients with LA-ESCC, and thus SUVsd was an optimum predictor for PD-L1 positive expression, which could help to explore the existence of immune checkpoints and select ESCC candidates for immunotherapy.
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Affiliation(s)
- Yaqing Zhao
- Department of General Affairs Section, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jiazhong Ren
- Department of Medical Imaging, PET-CT Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
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Arçay Öztürk A, Flamen P. FAP-targeted PET imaging in gastrointestinal malignancies: a comprehensive review. Cancer Imaging 2023; 23:79. [PMID: 37608378 PMCID: PMC10463504 DOI: 10.1186/s40644-023-00598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
F18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) plays a crucial role in tumour diagnosis, staging, and therapy response evaluation of various cancer types and has been a standard imaging modality used in clinical oncology practice for many years. However, it has certain limitations in evaluating some particular gastrointestinal cancer types due to low FDG-avidity or interphering physiological background activity. Fibroblast activation protein (FAP), a protein of the tumour microenvironment, is overexpressed in a wide range of cancers which makes it an attractive target for both tumour imaging and therapy. Recently, FAP-targeted radiopharmaceuticals are widely used in clinical research and achieved great results in tumour imaging. Considering the limitations of FDG PET/CT and the lack of physiological FAP-targeted tracer uptake in liver and intestinal loops, gastrointestinal cancers are among the most promising indications of FAP-targeted imaging. Herein, we present a comprehensive review of FAP-targeted imaging in gastrointestinal cancers in order to clarify the current and potential future role of this class of molecules in gastrointestinal oncology.
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Affiliation(s)
- Ayça Arçay Öztürk
- Department of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
| | - Patrick Flamen
- Department of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Liu G, Mao W, Yu H, Hu Y, Gu J, Shi H. One-stop [ 18F]FDG and [ 68Ga]Ga-DOTA-FAPI-04 total-body PET/CT examination with dual-low activity: a feasibility study. Eur J Nucl Med Mol Imaging 2023; 50:2271-2281. [PMID: 36971806 DOI: 10.1007/s00259-023-06207-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Positron emission tomography/computed tomography (PET/CT) based on fibroblast activation protein inhibitors (FAPI) has shown complementary values to 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]FDG) in cancer imaging. This study aimed to investigate the feasibility of a one-stop FDG-FAPI dual-tracer imaging protocol with dual-low activity for oncological imaging. METHODS Nineteen patients with malignancies underwent one-stop [18F]FDG (0.37 MBq/kg) PET (PETFDG) and dual-tracer PET 30-40 and 50-60 min (hereafter, PETD30-40 and PETD50-60, respectively) after additional injection of [68Ga]Ga-DOTA-FAPI-04 (0.925 MBq/kg), with a single diagnostic CT to generate the PET/CT. The lesion detection rate and tumor-to-normal ratios (TNRs) of tracer uptake were compared between PETFDG/CT and PETD50-60/CT and between PETD50-60/CT and PETD30-40/CT. In addition, a visual scoring system was established to compare the lesion detectability. RESULTS The dual-tracer PETD50-60 and PETD30-40/CT showed similar performance in detecting primary tumors but presented significantly higher lesion TNRs than PETFDG. Significantly, more metastases with higher TNRs were identified on PETD50-60 than PETFDG (491 vs. 261, P < 0.001). The dual-tracer PETD50-60 received significantly higher visual scores than single PETFDG (111 vs. 10) in demonstrating both primary tumors (12 vs. 2) and metastases (99 vs. 8). However, these differences were not significant between PETD50-60 and PETD30-40. These resulted in tumor upstaging in 44.4% patients taking PET/CT for initial assessment, and more recurrences (68 vs. 7) were identified in patients taking PET/CT for restaging, both on PETD50-60 and PETD30-40, compared to PETFDG. The reduced effective dosimetry per patient (26.2 ± 2.57 mSv) was equal to that of a single standard whole-body PET/CT. CONCLUSION The one-stop dual-tracer dual-low-activity PET imaging protocol combines the strengths of [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 with shorter duration and lesser radiation and is thus clinically applicable.
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Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wujian Mao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianying Gu
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
- Institute of Nuclear Medicine, Fudan University, Shanghai, China.
- Shanghai Institute of Medical Imaging, Shanghai, China.
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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Peng D, Cao J, Guo C, He J, Yang L, Zhang J, Yang J, Feng Y, Xu T, Chen Y. Influence of Cirrhosis on 68Ga-FAPI PET/CT in Intrahepatic Tumors. Radiology 2023; 307:e222448. [PMID: 37219440 DOI: 10.1148/radiol.222448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background Gallium 68 (68Ga)-labeled fibroblast activation protein inhibitor (FAPI) is of great diagnostic value for intrahepatic tumors. However, cirrhosis may lead to increased 68Ga-FAPI uptake in background liver, affecting the diagnostic ability of 68Ga-FAPI. Purpose To assess the effect of cirrhosis on liver parenchyma and intrahepatic tumor uptake of 68Ga-FAPI and to compare the ability of 68Ga-FAPI and fluorine 18 (18F)-labeled fluorodeoxyglucose (FDG) PET/CT to depict intrahepatic tumors in patients with cirrhosis. Materials and Methods In this secondary analysis of a prospective trial, patients who underwent both 68Ga-FAPI and 18F-FDG PET/CT and those who underwent only 68Ga-FAPI PET/CT between August 2020 and May 2022 were considered for inclusion in the cirrhotic or noncirrhotic group, respectively. Patients with cirrhosis were chosen via a comprehensive assessment of imaging and clinical data, and patients without cirrhosis were randomly selected. 68Ga-FAPI and 18F-FDG PET/CT data were measured by two radiologists. Between-groups and within-group data were tested with the Mann-Whitney U test and the Wilcoxon signed-rank test, respectively. Results A total of 39 patients with cirrhosis (median age, 58 years [IQR, 50-68]; 29 male; 24 intrahepatic tumors) and 48 patients without cirrhosis (median age, 59 years [IQR, 51-67]; 30 male; 23 intrahepatic tumors) were evaluated. In patients without intrahepatic tumors, the liver 68Ga-FAPI average standardized uptake value (SUVavg) was higher in the cirrhotic group than in the noncirrhotic group (median SUVavg, 1.42 [IQR, 0.55-2.85] vs 0.45 [IQR, 0.41-0.72]; P = .002). However, no difference was observed in the diagnosis of intrahepatic tumor sensitivity (98% vs 93%, respectively). When compared with 18F-FDG, the sensitivity of 68Ga-FAPI PET/CT in the detection of intrahepatic tumors in patients with cirrhosis (41% vs 98%, respectively) and maximum standardized uptake value of tumors (median SUVmax, 2.60 [IQR, 2.14-4.49] vs 6.68 [IQR, 4.65-10.08]; P < .001) were higher. Conclusion The sensitivity of 68Ga-FAPI in the diagnosis of intrahepatic tumors was not affected by cirrhosis, and diagnostic accuracy of 68Ga-FAPI was higher than that of 18F-FDG in patients with cirrhosis. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Dengsai Peng
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Jianpeng Cao
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Chunmei Guo
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Jing He
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Liping Yang
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Jinping Zhang
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Jian Yang
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Yue Feng
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Tingting Xu
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
| | - Yue Chen
- From the Departments of Nuclear Medicine (D.P., C.G., L.Y., J.Y., Y.F., T.X., Y.C.) and Pathology (J.Z.), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St, Jiangyang District, Luzhou 646000, PR China; Department of Nuclear Medicine, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, PR China (J.C.); Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, PR China (J.H.)
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van den Hoven AF, Keijsers RGM, Lam MGEH, Glaudemans AWJM, Verburg FA, Vogel WV, Lavalaye J. Current research topics in FAPI theranostics: a bibliometric analysis. Eur J Nucl Med Mol Imaging 2023; 50:1014-1027. [PMID: 36437424 DOI: 10.1007/s00259-022-06052-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The study aimed to provide a comprehensive bibliometric overview of the current scientific publications on fibroblast activation protein inhibitor (FAPI) positron emission tomography imaging and radionuclide therapy. METHODS A PubMed search was performed to identify all MEDLINE-indexed publications on FAPI imaging and radionuclide therapy. The last update was performed on 31 May 2022. An online database of this literature was created, and hierarchical topic-related tags were subsequently assigned to all relevant studies. Frequency analysis was used to evaluate the distribution of the following characteristics: first author's country of origin, journal of publication, study design, imaging techniques and radiopharmaceutical used, histopathological correlation, the type of cancer, and benign disease/uptake types evaluated. RESULTS A total of 294 relevant publications on original studies were identified, consisting of 209 (71%) case reports/series and 85 cohort studies (29%). The majority of studies focused on imaging topics, predominantly comparing uptake on FAPI-PET/CT with 2-[18F]FDG-PET/CT, anatomical imaging, and/or histopathology results. 68% of studies focused on malignancies, with gastro-intestinal cancer, hepato-pancreato-biliary cancer, mixed cancers/metastases, lung cancer, sarcoma, head and neck cancer, and breast cancer being the most frequently reported. 42% of studies focused on benign disease categories, with cardiovascular, musculoskeletal, HPB, head and neck, and IgG4-related disease as most common categories. 16/294 (5%) studies focused on radionuclide therapy, with preliminary reports of acceptable toxicity profiles, tumour activity retention, and suggestion of disease control. CONCLUSION FAPI research is rapidly expanding from diagnostic studies in malignancies and benign diseases to the first reports of salvage radionuclide therapy. The research activity needs to shift now from low-level-of-evidence case reports and series to prospectively designed studies in homogenous patient groups to provide evidence on how and in which clinical situations FAPI theranostics can be of added value to clinical care. We have provided an overview of current research topics to build upon.
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Affiliation(s)
- Andor F van den Hoven
- Department of Nuclear Medicine, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
| | - Ruth G M Keijsers
- Department of Nuclear Medicine, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Frederik A Verburg
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jules Lavalaye
- Department of Nuclear Medicine, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
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[ 68Ga]Ga-FAPI PET for the evaluation of digestive system tumors: systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2023; 50:908-920. [PMID: 36326867 DOI: 10.1007/s00259-022-06021-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Digestive system tumors are a group of tumors with high incidence in the world nowadays. The assessment of digestive system tumor metastasis by conventional imaging seems to be unsatisfactory. [68Ga]Ga-FAPI, which has emerged in recent years, seems to be able to evaluate digestive system tumor metastasis. We aimed to summarize the current evidence of [68Ga]Ga-FAPI PET/CT or PET/MR for the assessment of primary tumors, lymph node metastases, and distant metastases in digestive system tumors. Besides, we also aimed to perform a meta-analysis of the sensitivity of [68Ga]Ga-FAPI PET diagnosis to discriminate between digestive system tumors, primary lesions, and non-primary lesions (lymph node metastases and distant metastases). MATERIALS AND METHODS PubMed, MEDLINE and Cochrane Library databases were searched from the beginning of the database build to August 12, 2022. All studies undergoing [68Ga]Ga-FAPI PET for the evaluation of digestive tumors were included in the screening and review. Screening and full text review was performed by 3 investigators and data extraction was performed by 2 investigators. Risk of bias was examined with the QUADAS-2 criteria. Diagnostic test meta-analysis was performed with a random-effects model. RESULTS A total of 541 studies were retrieved. Finally, 22 studies were selected for the systematic review and 18 studies were included in the meta-analysis. In the 18 publications, a total of 524 patients with digestive system tumors, 459 primary tumor lesions of digestive system tumors, and 1921 metastatic lesions of digestive system tumors were included in the meta-analysis. Based on patients, the sensitivity of [68Ga]Ga-FAPI PET for the diagnosis of digestive system tumors was 0.98 (95% CI: 0.94-0.99). Based on lesions, the sensitivity of [68Ga]Ga-FAPI PET for the diagnostic evaluation of primary tumor lesions of the digestive system was 0.97 (95% CI: 0.93-0.99); the sensitivity of [68Ga]Ga-FAPI PET for the diagnostic evaluation of non-primary lesions (lymph node metastases and distant metastases) of the digestive system tumors was 0.94 (95% CI: 0.79-0.99). CONCLUSION [68Ga]Ga-FAPI PET has high accuracy and its sensitivity is at a high level for the diagnostic evaluation of digestive system tumors. Clinicians, nuclear medicine physicians, and radiologists may consider using [68Ga]Ga-FAPI PET/CT or PET/MR in the evaluation of primary tumors, lymph node metastases, and distant metastases in digestive system tumors.
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Miao Y, Feng R, Guo R, Huang X, Hai W, Li J, Yu T, Qu Q, Zhang M, Shangguan C, Mi J, Zhu Z, Li B. Utility of [68Ga]FAPI-04 and [18F]FDG dual-tracer PET/CT in the initial evaluation of gastric cancer. Eur Radiol 2022; 33:4355-4366. [PMID: 36522509 PMCID: PMC10182135 DOI: 10.1007/s00330-022-09321-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/29/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Abstract
Objectives
We aimed to investigate the role of [68Ga]FAPI-04 and [18F]FDG dual-tracer PET/CT for the initial assessment of gastric cancer and to explore the factors associated with their uptake.
Methods
This study enrolled 62 patients with histopathologically confirmed gastric cancer. We compared the diagnostic performance of [68Ga]FAPI-04, [18F]FDG, and combined dual-tracer PET/CT. The standardized uptake value (SUV) and tumor-to-background ratio (TBR) were also measured, and the factors that influence tracer uptake were analyzed.
Results
[68Ga]FAPI-04 PET/CT detected more primary lesions (90.3% vs 77.4%, p = 0.008) and peritoneal metastases (91.7% vs 41.7%, p = 0.031) and demonstrated higher SUVmax and TBR values (p < 0.001) of primary lesions compared to [18F]FDG PET/CT. Dual-tracer PET/CT significantly improved the diagnostic sensitivity for the detection of distant metastases, compared with stand-alone [18F]FDG (97.1% vs 73.5%, p = 0.008) or [68Ga]FAPI-04 (97.1% vs 76.5%, p = 0.016) PET/CT. Subsequently, treatment strategies were changed in nine patients following [68Ga]FAPI-04 and [18F]FDG dual-tracer PET/CT. Nevertheless, [68Ga]FAPI-04 uptake was primarily influenced by the size and invasion depth of the tumor. Both [68Ga]FAPI-04 and [18F]FDG PET/CT showed limited sensitivity for detecting early gastric cancer (EGC) (37.5% vs 25.0%, p > 0.05).
Conclusions
In this initial study, [68Ga]FAPI-04 and [18F]FDG dual-tracer PET/CT were complementary and improved sensitivity for the detection of distant metastases pre-treatment in gastric cancer and could improve treatment stratification in the future. [68Ga]FAPI-04 had limited efficacy in detecting EGC.
Key Points
•[68Ga]FAPI-04 and[18F]FDG dual-tracer PET/CT are complementary to each other for improving diagnostic sensitivity in the initial evaluation of distant metastases from gastric cancer.
•[68Ga]FAPI-04 PET/CT showed limited sensitivity in detecting EGC.
• Need for further validation in a larger multi-centre prospective study.
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Affiliation(s)
- Ying Miao
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Runhua Feng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Rui Guo
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Xinyun Huang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Wangxi Hai
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Jian Li
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Teng Yu
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Qian Qu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Min Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Chengfang Shangguan
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Jun Mi
- Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Zhenggang Zhu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, 197 Ruijin Er Road, Shanghai, 200025, China.
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11
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Chen D, Chang C, Zhang Y, Yang S, Wang G, Lin L, Zhao X, Zhao K, Su X. Different Features of 18F-FAPI, 18F-FDG PET/CT and MRI in the Evaluation of Extrahepatic Metastases and Local Recurrent Hepatocellular Carcinoma (HCC): A Case Report and Review of the Literature. Cancer Manag Res 2022; 14:2649-2655. [PMID: 36090470 PMCID: PMC9462837 DOI: 10.2147/cmar.s374916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Recurrence and metastasis are important causes of postoperative death in most HCC patients. Conventional imaging modalities such as 18F-FDG PET/CT and enhanced MRI are still unsatisfactory in evaluating these patients in the clinical setting. PET/CT imaging with a radiolabeled fibroblast activation protein inhibitor (FAPI) has emerged as a new imaging technique for the diagnosis and radiotherapy of malignant tumors. While many studies have focused on the diagnostic accuracy of intrahepatic primary HCC, the evaluation of recurrent and metastatic HCC remains only poorly investigated. Case Presentation A 71-year-old man with a five-year history of HCC after radical resection underwent 18F-FDG PET/CT due to further surgery for tumor recurrence, which revealed two iso-metabolic lesions in the right peritoneum and a hypo-metabolic lesion in the right liver. 18F-FAPI PET/CT was performed to further complement 18F-FDG PET/CT in the detection of these suspected metastatic lesions. Importantly, multiple diffuse intense radioactivity was shown in the hepatic capsule, suggesting metastatic lesions, but a wedge-shaped elevated 18F-FAPI uptake disorder around the FDG-unavid necrotic lesion after radiofrequency ablation (RFA) demonstrated benign stromal fibrosis. Conclusion This case suggested that 18F-FAPI may have an advantage over 18F-FDG in detecting peritoneal metastasis even in tiny or early hepatic capsules of HCC, but its false positives due to postoperative stromal fibrosis should be noted. Wedge- or strip-shaped FAPI-avid lesions with sharp edges may be post-treatment stromal fibrosis.
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Affiliation(s)
- Donghe Chen
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Chengdong Chang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yafei Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Shuye Yang
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Guolin Wang
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Lili Lin
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Xin Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Kui Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Xinhui Su
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
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Zhang S, Wang W, Xu T, Ding H, Li Y, Liu H, Huang Y, Liu L, Du T, Zhao Y, Chen Y, Qiu L. Comparison of Diagnostic Efficacy of [68Ga]Ga-FAPI-04 and [18F]FDG PET/CT for Staging and Restaging of Gastric Cancer. Front Oncol 2022; 12:925100. [PMID: 35847877 PMCID: PMC9283765 DOI: 10.3389/fonc.2022.925100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose This study aimed to compare the potential diagnostic efficacy of gallium68-fibroblast-activation protein inhibitor ([68Ga]Ga-FAPI-04) and fluorine18-fluorodeoxyglucose ([18F]-FDG) positron emission tomography-computed tomography (PET/CT) for primary tumors, lymph nodes, and distant metastatic lesions of gastric cancer (GC), and to explore the effects of [68Ga]Ga-FAPI-04 and [18F]-FDG on tumor staging and restaging in GC. Methods This single-center retrospective study (NCT2100044131) was conducted at the Affiliated Hospital of the Southwest Medical University between June 2020 and December 2021. Images of patients with GC who were pathologically confirmed and underwent contemporaneous [18F]-FDG and [68Ga]Ga-FAPI-04 PET/CT within 1 week were analyzed. The diagnostic efficacy of [68Ga]Ga-FAPI-04 PET/CT and [18F]-FDG PET/CT for TNM staging of GC was compared using McNemar test. The maximum standard uptake value (SUVmax) of each lesion in the two imaging types was compared using the Mann-Whitney U test. Results In total, 25 patients with GC (mean age, 56 ± 12 years) were evaluated. [68Ga]Ga-FAPI-04 PET/CT exhibited higher sensitivity compared to [18F]-FDG PET/CT for detecting primary tumors (18/19 [94.74%] vs. 13/19 [68.42%], χ2 = 6.866, P < 0.01), lymph node metastasis (75/77 [97.40%] vs. 32/77 [41.56%], χ2 = 2.888, P =0.089), and distant metastases (275/283 [97.17%] vs. 122/283 [43.11%], χ2 = 11.858, P < 0.01). [68Ga]Ga-FAPI-04 accumulation was significantly higher than that of [18F]FDG in tumors (median SUVmax, 10.28 vs 3.20; U=59.00, P < 0.01), lymph node metastasis metastases (median SUVmax, 9.20 vs 3.15; U=53.50, P < 0.01), and distant metastases (median SUVmax, 8.00 vs 4.20; U=200.00, P < 0.01). Compared to [18F]-FDG PET/CT, [68Ga]Ga-FAPI-04 PET/CT resulted in new oncological findings in 14/25 patients and corrected tumor staging or restaging in 7/25 patients. Conclusion Our preliminary results regarding the impact of [68Ga]Ga-FAPI-04 PET/CT on tumor staging highlight the potential of this approach for increasing the accuracy of GC diagnosis, which may facilitate treatment decision-making.
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Affiliation(s)
- Shumao Zhang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Wei Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Tingting Xu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Haoyuan Ding
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Yi Li
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Huipan Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Yinxue Huang
- Department of Geriatric Psychiatry, The Fourth People’s Hospital of Chengdu, Chengdu, China
- Department of Geriatric Psychiatry, The Clinical Hospital of Chengdu Brain Science Institute, Ministry of Education (MOE) Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Lin Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Tao Du
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Yan Zhao
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
- *Correspondence: Yue Chen, ; Lin Qiu,
| | - Lin Qiu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China
- *Correspondence: Yue Chen, ; Lin Qiu,
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13
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Huang R, Pu Y, Huang S, Yang C, Yang F, Pu Y, Li J, Chen L, Huang Y. FAPI-PET/CT in Cancer Imaging: A Potential Novel Molecule of the Century. Front Oncol 2022; 12:854658. [PMID: 35692767 PMCID: PMC9174525 DOI: 10.3389/fonc.2022.854658] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/07/2022] [Indexed: 12/13/2022] Open
Abstract
Fibroblast activation protein (FAP), a type II transmembrane serine protease, is highly expressed in more than 90% of epithelial tumors and is closely associated with various tumor invasion, metastasis, and prognosis. Using FAP as a target, various FAP inhibitors (FAPIs) have been developed, most of which have nanomolar levels of FAP affinity and high selectivity and are used for positron emission tomography (PET) imaging of different tumors. We have conducted a systematic review of the available data; summarized the biological principles of FAPIs for PET imaging, the synthesis model, and metabolic characteristics of the radiotracer; and compared the respective values of FAPIs and the current mainstream tracer 18F-Fludeoxyglucose (18F-FDG) in the clinical management of tumor and non-tumor lesions. Available research evidence indicates that FAPIs are a molecular imaging tool complementary to 18F-FDG and are expected to be the new molecule of the century with better imaging effects than 18F-FDG in a variety of cancers, including gastrointestinal tumors, liver tumors, breast tumors, and nasopharyngeal carcinoma.
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Affiliation(s)
- Rong Huang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yu Pu
- Medical Imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China
| | - Shun Huang
- Department of Nuclear medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Conghui Yang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Fake Yang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yongzhu Pu
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Jindan Li
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Long Chen
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China.,Medical Imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China
| | - Yunchao Huang
- Department of Thoracic Surgery I, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
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Yang T, Ma L, Hou H, Gao F, Tao W. FAPI PET/CT in the Diagnosis of Abdominal and Pelvic Tumors. Front Oncol 2022; 11:797960. [PMID: 35059319 PMCID: PMC8763785 DOI: 10.3389/fonc.2021.797960] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022] Open
Abstract
Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) is currently a standard imaging examination used in clinical practice, and plays an essential role in preoperative systemic evaluation and tumor staging in patients with tumors. However, 18F-FDG PET/CT has certain limitations in imaging of some tumors, like gastric mucus adenocarcinoma, highly differentiated hepatocellular carcinoma, renal cell carcinoma, and peritoneal metastasis. Therefore, to search for new tumor diagnosis methods has always been an important topic in radiographic imaging research. Fibroblast activation protein (FAP) is highly expressed in many epithelial carcinomas, and various isotope-labelled fibroblast activation protein inhibitors (FAPI) show lower uptake in the brain and abdominal tissues than in tumor, thus achieving high image contrast and good tumor delineation. In addition to primary tumors, FAPI PET/CT is better than FDG PET/CT for detecting lymph nodes and metastases. Additionally, the highly selective tumor uptake of FAPI may open up new application areas for the non-invasive characterization, staging of tumors, as well as monitoring tumor treatment efficacy. This review focuses on the recent research progress of FAPI PET/CT in the application to abdominal and pelvic tumors, with the aim of providing new insights for diagnostic strategies for tumor patients, especially those with metastases.
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Affiliation(s)
- Tianshuo Yang
- Department of Nuclear Medicine, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Long Ma
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haodong Hou
- Key Laboratory for Experimental Teratology of the Ministry of Education and Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Feng Gao
- Key Laboratory for Experimental Teratology of the Ministry of Education and Center for Experimental Nuclear Medicine, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Weijing Tao
- Department of Nuclear Medicine, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
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