Ximin Shi1, Haiqun Xing1, Xiaobo Yang2, Fang Li1, Shaobo Yao3, Jia Congwei4, Haitao Zhao2, Marcus Hacker5, Li Huo6, Xiang Li5. 1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Chinese Academy of Medical Science and Peking Union Medical College, 1# Shuaifuyuan, Dongcheng District, Beijing, 100730, China. 2. Department of Hepatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. Department of Nuclear Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. 4. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 5. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria. 6. Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Chinese Academy of Medical Science and Peking Union Medical College, 1# Shuaifuyuan, Dongcheng District, Beijing, 100730, China. huoli@pumch.cn.
Abstract
PURPOSE: This study aimed to compare the performance of 68Ga-labelled fibroblast activating protein inhibitor (FAPI) PET and 18F-FDG PET for imaging of hepatic tumours. METHODS: We prospectively assessed 20 patients with suspected intrahepatic lesions. Tumour radiological features, pathology, or follow-up examinations were assessed as ground truth in correlation with PET scans. Semiquantitative analysis was additionally performed by measuring the standardised uptake value (SUV). Tumour-to-liver background ratios (TBR) were calculated and compared between 68Ga-FAPI PET and 18F-FDG PET. FAPI expression was assessed by immunochemistry in samples obtained from 7 patients with hepatocellular carcinomas (HCC)/intrahepatic cholangiocarcinoma (ICC) or granulomas. RESULTS: Primary intrahepatic tumours, including 16 HCC in 14 patients and 4 ICC in 3 patients with extrahepatic metastases, were determined by histology (n = 14) and clinical examinations (n = 3). Based on visual analysis, 17 patients presented elevated 68Ga-FAPI uptake (sensitivity: 100%, specificity: 100%), while 7 patients presented 18F-FDG avid tumours (sensitivity: 58.8%, specificity: 100%). 68Ga-FAPI PET/CT identified 17 extrahepatic metastases vs. 13 in 18F-FDG PET/CT in 2 ICC patients. Three benign liver nodules in three patients showed negligible uptake in dual-PET scans. The SUVmax_HCC = 8.47 ± 4.06 and TBRmax_HCC = 7.13 ± 5.52, and SUVmax_ICC = 14.14 ± 2.20 TBRmax_ICC = 26.46 ± 4.94 in 68Ga-FAPI-04 PET/CT were significantly higher than the 18F-FDG uptake presenting SUVmax_HCC = 4.86 ± 3.58 and TBRmax_HCC = 2.39 ± 2.21, and SUVmax_ICC = 9.19 ± 3.60 and TBRmax_ICC = 2.39 ± 2.21 (all p values < 0.05). ICC patients showed higher levels of FAPI uptake in the primary hepatic lesions compared to extrahepatic metastases, TBRmax_ICC = 15.18 ± 5.80 (p = 0.04). CONCLUSIONS: 68Ga-FAPI PET-CT has superior potential in the detection of primary hepatic malignancy compared to 18F-FDG.
PURPOSE: This study aimed to compare the performance of 68Ga-labelled fibroblast activating protein inhibitor (FAPI) PET and 18F-FDG PET for imaging of hepatic tumours. METHODS: We prospectively assessed 20 patients with suspected intrahepatic lesions. Tumour radiological features, pathology, or follow-up examinations were assessed as ground truth in correlation with PET scans. Semiquantitative analysis was additionally performed by measuring the standardised uptake value (SUV). Tumour-to-liver background ratios (TBR) were calculated and compared between 68Ga-FAPI PET and 18F-FDG PET. FAPI expression was assessed by immunochemistry in samples obtained from 7 patients with hepatocellular carcinomas (HCC)/intrahepatic cholangiocarcinoma (ICC) or granulomas. RESULTS:Primary intrahepatic tumours, including 16 HCC in 14 patients and 4 ICC in 3 patients with extrahepatic metastases, were determined by histology (n = 14) and clinical examinations (n = 3). Based on visual analysis, 17 patients presented elevated 68Ga-FAPI uptake (sensitivity: 100%, specificity: 100%), while 7 patients presented 18F-FDGavid tumours (sensitivity: 58.8%, specificity: 100%). 68Ga-FAPI PET/CT identified 17 extrahepatic metastases vs. 13 in 18F-FDG PET/CT in 2 ICC patients. Three benign liver nodules in three patients showed negligible uptake in dual-PET scans. The SUVmax_HCC = 8.47 ± 4.06 and TBRmax_HCC = 7.13 ± 5.52, and SUVmax_ICC = 14.14 ± 2.20 TBRmax_ICC = 26.46 ± 4.94 in 68Ga-FAPI-04 PET/CT were significantly higher than the 18F-FDG uptake presenting SUVmax_HCC = 4.86 ± 3.58 and TBRmax_HCC = 2.39 ± 2.21, and SUVmax_ICC = 9.19 ± 3.60 and TBRmax_ICC = 2.39 ± 2.21 (all p values < 0.05). ICC patients showed higher levels of FAPI uptake in the primary hepatic lesions compared to extrahepatic metastases, TBRmax_ICC = 15.18 ± 5.80 (p = 0.04). CONCLUSIONS:68Ga-FAPI PET-CT has superior potential in the detection of primary hepatic malignancy compared to 18F-FDG.
Authors: M A Khan; C S Combs; E M Brunt; V J Lowe; M K Wolverson; H Solomon; B T Collins; A M Di Bisceglie Journal: J Hepatol Date: 2000-05 Impact factor: 25.083
Authors: Robert L Zimmerman; Melissa Burke; Nancy A Young; Charalambos C Solomides; Marluce Bibbo Journal: Cancer Date: 2002-02-25 Impact factor: 6.860
Authors: Shumao Zhang; Wei Wang; Tingting Xu; Haoyuan Ding; Yi Li; Huipan Liu; Yinxue Huang; Lin Liu; Tao Du; Yan Zhao; Yue Chen; Lin Qiu Journal: Front Oncol Date: 2022-07-01 Impact factor: 5.738
Authors: Lukas Kessler; Justin Ferdinandus; Nader Hirmas; Sebastian Bauer; Uta Dirksen; Fadi Zarrad; Michael Nader; Michal Chodyla; Aleksandar Milosevic; Lale Umutlu; Martin Schuler; Lars Erik Podleska; Hans-Ulrich Schildhaus; Wolfgang P Fendler; Rainer Hamacher Journal: J Nucl Med Date: 2021-04-30 Impact factor: 11.082