Fibroblast-Activation Protein PET and Histopathology in a Single-Center Database of 324 Patients and 21 Tumor Entities

被引:38
作者
Hirmas, Nader [1 ,2 ]
Hamacher, Rainer [3 ,4 ]
Sraieb, Miriam [1 ,2 ]
Ingenwerth, Marc [5 ]
Kessler, Lukas [1 ,2 ]
Pabst, Kim M. [1 ,2 ]
Barbato, Francesco [1 ,2 ]
Lueckerath, Katharina [1 ,2 ]
Kasper, Stefan [3 ,4 ]
Nader, Michael [1 ,2 ]
Schildhaus, Hans-Ulrich [5 ,6 ]
Kesch, Claudia [7 ]
von Tresckow, Bastian [4 ,8 ]
Hanoun, Christine [4 ,8 ]
Hautzel, Hubertus [1 ,2 ]
Aigner, Clemens [4 ,9 ]
Glas, Martin [4 ,10 ]
Stuschke, Martin [4 ,11 ]
Kummel, Sherko [12 ,13 ]
Harter, Philipp [14 ]
Lugnier, Celine [15 ]
Uhl, Waldemar [16 ]
Niedergethmann, Marco [17 ]
Hadaschik, Boris [7 ]
Grunwald, Viktor [7 ]
Siveke, Jens T. [18 ,19 ,20 ]
Herrmann, Ken [1 ,2 ]
Fendler, Wolfgang P. [1 ,2 ]
机构
[1] Univ Duisburg Essen, Dept Nucl Med, Essen, Germany
[2] Univ Hosp Essen, German Canc Consortium DKTK, Essen, Germany
[3] Univ Duisburg Essen, West German Canc Ctr, Dept Med Oncol, Essen, Germany
[4] DKTK Univ Hosp Essen, Essen, Germany
[5] Univ Hosp Essen, Inst Pathol, Essen, Germany
[6] Targos Mol Pathol Inc, Kassel, Germany
[7] Univ Duisburg Essen, Dept Urol, Essen, Germany
[8] Univ Duisburg Essen, Dept Hematol & Stem Cell Transplantat, Essen, Germany
[9] Univ Duisburg Essen, Dept Thorac Surg & Thorac Endoscopy, Essen, Germany
[10] Univ Duisburg Essen, Div Clin Neurooncol, Dept Neurol, Essen, Germany
[11] Univ Duisburg Essen, Dept Radiat Therapy, Essen, Germany
[12] Kliniken Essen Mitte, Breast Unit, Essen, Germany
[13] Charite Univ Med Berlin, Dept Gynecol Breast Ctr, Berlin, Germany
[14] Evang Kliniken Essen Mitte, Dept Gynecol & Gynecol Oncol, Essen, Germany
[15] Ruhr Univ Bochum, Dept Hematol & Oncol Palliat Care, Bochum, Germany
[16] Ruhr Univ Bochum, Dept Gen & Visceral Surg, Bochum, Germany
[17] Alfried Krupp Hosp, Clin Gen & Visceral Surg, Essen, Germany
[18] Univ Hosp Essen, Bridge Inst Expt Tumor Therapy, West German Canc Ctr, Essen, Germany
[19] DKTK Partner Site Essen, Div Solid Tumor Translat Oncol, Heidelberg, Germany
[20] German Canc Res Ctr, Heidelberg, Germany
关键词
FAPI; PET; oncology; staging; theranostic; CANCER; CARCINOMA;
D O I
10.2967/jnumed.122.264689
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
We present an overview of our prospective fibroblast-activation pro-tein inhibitor (FAPI) registry study across a 3-y period, with head-to -head comparison of tumor uptake in 68Ga-FAPI and 18F-FDG PET, as well as FAP immunohistochemistry. Methods: This is an interim anal-ysis of the ongoing 68Ga-FAPI PET prospective observational trial at our department. Patients who underwent clinical imaging with 68Ga-FAPI PET between October 2018 and October 2021 were included. Tracer uptake was quantified by SUVmax for tumor lesions and by SUVmean for normal organs. PET tumor volume (40% isocontour) and tumor-to-background ratios were calculated. Correlation between SUVmax and FAP staining in tissue samples was analyzed. Results: In total, 324 patients with 21 different tumor entities underwent 68Ga-FAPI imaging; 237 patients additionally received 18F-FDG PET. The most common tumor entities were sarcoma (131/324, 40%), pancre-atic cancer (67/324, 21%), and primary tumors of the brain (22/324, 7%). The mean primary tumor SUVmax was significantly higher for 68Ga-FAPI than 18F-FDG among pancreatic cancer (13.2 vs. 6.1, P < 0.001) and sarcoma (14.3 vs. 9.4, P < 0.001), and the same was true for mean SUVmax in metastatic lesions of pancreatic cancer (9.4 vs. 5.5, P < 0.001). Mean primary tumor maximum tumor-to-background ratio was significantly higher for 68Ga-FAPI than 18F-FDG across sev-eral tumor entities, most prominently pancreatic cancer (14.7 vs. 3.0, P < 0.001) and sarcoma (17.3 vs. 4.7, P < 0.001). Compared with 18F-FDG, 68Ga-FAPI showed superior detection for locoregional dis-ease in sarcoma (52 vs. 48 total regions detected) and for distant met-astatic disease in both sarcoma (137 vs. 131) and pancreatic cancer (65 vs. 57), respectively. Among 61 histopathology samples, there was a positive correlation between 68Ga-FAPI SUVmax and overall FAP immunohistochemistry score (r = 0.352, P = 0.005). Conclusion: 68Ga-FAPI demonstrates higher absolute uptake in pancreatic cancer and sarcoma, as well as higher tumor-to-background uptake along with improved tumor detection for pancreatic cancer, sarcoma, and other tumor entities when compared with 18F-FDG. 68Ga-FAPI is a new tool for tumor staging with theranostic potential.
引用
收藏
页码:711 / 716
页数:6
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