Chunxia Qin1,2, Yangmeihui Song3,4, Xi Liu5, Yongkang Gai3,4, Qingyao Liu3,4, Weiwei Ruan3,4, Fang Liu3,4, Fan Hu3,4, Xiaoli Lan6,7. 1. Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, China. qin_chunxia@hust.edu.cn. 2. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China. qin_chunxia@hust.edu.cn. 3. Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, China. 4. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China. 5. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, China. 6. Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, China. xiaoli_lan@hust.edu.cn. 7. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China. xiaoli_lan@hust.edu.cn.
Abstract
PURPOSE: To describe the uptake of 68Gallium-labelled fibroblast activation protein inhibitor (68Ga-FAPI) in the bones and joints for better understanding of the role of 68Ga-FAPI PET in benign and malignant bone lesions and joint diseases. METHODS: All 129 68Ga-FAPI PET/MR or PET/CT scans from June 1, 2020, to February 20, 2021, performed at our PET center were retrospectively reviewed. Foci of elevated 68Ga-FAPI uptake in the bones and joints were identified. All lesions were divided into malignant and benign diseases. Benign lesions included osteofibrous dysplasia, periodontitis, degenerative bone diseases, arthritis, and other inflammatory or trauma-related abnormalities. The number, locations, and SUVmax of all lesions were recorded and analyzed. The detectability of 68Ga-FAPI PET and 18F-FDG PET in patients who had two scans was also compared. RESULTS: Elevated uptake of 68Ga-FAPI in/around the bones and joints was found in 82 cases (63.57%). A total of 295 lesions were identified, including 94 (31.9%) malignant lesions (all were metastases) and 201 (68.1%) benign lesions. The benign lesions consisted of 13 osteofibrous dysplasia, 48 degenerative bone disease, 33 periodontitis, 56 arthritis, and 51 other inflammatory or trauma-related abnormalities. The spine, shoulder joint, alveolar ridge, and pelvis were the most commonly involved locations. Bone metastases were mainly distributed in the spine, pelvis, and ribs. Among benign diseases, periodontitis and arthritis are site-specific. The mean SUVmax of bone metastases was significantly higher than that of benign diseases (7.14 ± 4.33 vs. 3.57 ± 1.60, p < 0.001), but overlap existed. The differences in SUVmax among subgroups of benign diseases were statistically significant (p < 0.001), with much higher uptake in periodontitis (4.45 ± 1.17). 68Ga-FAPI PET identified much more lesions than 18F-FDG PET (104 vs. 48) with higher uptake value. CONCLUSION: 68Ga-FAPI accumulated in both bone metastases and some benign diseases of the bones and joints. Although the uptake of 68Ga-FAPI was often higher in bone metastases, this finding cannot be used to distinguish between benign and malignant lesions. 68Ga-FAPI PET also has the potential to locate and evaluate the extent of both malignant tumor and benign diseases in bones and joints. TRIAL REGISTRATION: NCT04554719, NCT04605939. Registered September 8, 2020 and October 25, 2020-retrospectively registered, http://clinicaltrails.gov/show/NCT04554719 ; http://clinicaltrails.gov/show/NCT04605939.
PURPOSE: To describe the uptake of 68Gallium-labelled fibroblast activation protein inhibitor (68Ga-FAPI) in the bones and joints for better understanding of the role of 68Ga-FAPI PET in benign and malignant bone lesions and joint diseases. METHODS: All 129 68Ga-FAPI PET/MR or PET/CT scans from June 1, 2020, to February 20, 2021, performed at our PET center were retrospectively reviewed. Foci of elevated 68Ga-FAPI uptake in the bones and joints were identified. All lesions were divided into malignant and benign diseases. Benign lesions included osteofibrous dysplasia, periodontitis, degenerative bone diseases, arthritis, and other inflammatory or trauma-related abnormalities. The number, locations, and SUVmax of all lesions were recorded and analyzed. The detectability of 68Ga-FAPI PET and 18F-FDG PET in patients who had two scans was also compared. RESULTS: Elevated uptake of 68Ga-FAPI in/around the bones and joints was found in 82 cases (63.57%). A total of 295 lesions were identified, including 94 (31.9%) malignant lesions (all were metastases) and 201 (68.1%) benign lesions. The benign lesions consisted of 13 osteofibrous dysplasia, 48 degenerative bone disease, 33 periodontitis, 56 arthritis, and 51 other inflammatory or trauma-related abnormalities. The spine, shoulder joint, alveolar ridge, and pelvis were the most commonly involved locations. Bone metastases were mainly distributed in the spine, pelvis, and ribs. Among benign diseases, periodontitis and arthritis are site-specific. The mean SUVmax of bone metastases was significantly higher than that of benign diseases (7.14 ± 4.33 vs. 3.57 ± 1.60, p < 0.001), but overlap existed. The differences in SUVmax among subgroups of benign diseases were statistically significant (p < 0.001), with much higher uptake in periodontitis (4.45 ± 1.17). 68Ga-FAPI PET identified much more lesions than 18F-FDG PET (104 vs. 48) with higher uptake value. CONCLUSION: 68Ga-FAPI accumulated in both bone metastases and some benign diseases of the bones and joints. Although the uptake of 68Ga-FAPI was often higher in bone metastases, this finding cannot be used to distinguish between benign and malignant lesions. 68Ga-FAPI PET also has the potential to locate and evaluate the extent of both malignant tumor and benign diseases in bones and joints. TRIAL REGISTRATION: NCT04554719, NCT04605939. Registered September 8, 2020 and October 25, 2020-retrospectively registered, http://clinicaltrails.gov/show/NCT04554719 ; http://clinicaltrails.gov/show/NCT04605939.
Authors: Thomas Lindner; Anastasia Loktev; Annette Altmann; Frederik Giesel; Clemens Kratochwil; Jürgen Debus; Dirk Jäger; Walter Mier; Uwe Haberkorn Journal: J Nucl Med Date: 2018-04-06 Impact factor: 10.057
Authors: Thomas Lindner; Annette Altmann; Susanne Krämer; Christian Kleist; Anastasia Loktev; Clemens Kratochwil; Frederik Giesel; Walter Mier; Frederik Marme; Jürgen Debus; Uwe Haberkorn Journal: J Nucl Med Date: 2020-03-13 Impact factor: 10.057
Authors: Clemens Kratochwil; Paul Flechsig; Thomas Lindner; Labidi Abderrahim; Annette Altmann; Walter Mier; Sebastian Adeberg; Hendrik Rathke; Manuel Röhrich; Hauke Winter; Peter K Plinkert; Frederik Marme; Matthias Lang; Hans-Ulrich Kauczor; Dirk Jäger; Jürgen Debus; Uwe Haberkorn; Frederik L Giesel Journal: J Nucl Med Date: 2019-04-06 Impact factor: 10.057
Authors: Anastasia Loktev; Thomas Lindner; Walter Mier; Jürgen Debus; Annette Altmann; Dirk Jäger; Frederik Giesel; Clemens Kratochwil; Philippe Barthe; Christian Roumestand; Uwe Haberkorn Journal: J Nucl Med Date: 2018-04-06 Impact factor: 10.057
Authors: Frederik L Giesel; Clemens Kratochwil; Thomas Lindner; Manfred M Marschalek; Anastasia Loktev; Wencke Lehnert; Jürgen Debus; Dirk Jäger; Paul Flechsig; Annette Altmann; Walter Mier; Uwe Haberkorn Journal: J Nucl Med Date: 2018-08-02 Impact factor: 10.057