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[68Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of gastric cancer: comparison with [18F]FDG PET/CT
Ist Teil von
European journal of nuclear medicine and molecular imaging, 2022-07, Vol.49 (8), p.2960-2971
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2022
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Purpose
This study aimed to compare the performance of [
68
Ga]Ga-DOTA-FAPI-04 and [
18
F]FDG PET/CT in the evaluation of primary and metastatic lesions of gastric cancer.
Methods
Fifty-six patients with histologically proven gastric carcinomas were enrolled in this study, including 45 patients for staging and 11 patients for restaging after surgery. Each patient underwent both [
18
F]FDG and [
68
Ga]Ga-DOTA-FAPI-04 PET/CT within 1 week. The activity of tracer accumulation in lesions was assessed by maximum standardized uptake value (SUV
max
) and TBR (lesions SUV
max
/ascending aorta SUV
mean
). Histological workup served as a standard of reference. If tissue diagnosis was not applicable, the follow-up data including the results of laboratory tests and medical imaging could also serve as a reference.
Results
[
68
Ga]Ga-DOTA-FAPI-04 PET/CT was comparable to [
18
F]FDG on detecting primary tumors and lymph node (LN) metastases, whereas [
68
Ga]Ga-DOTA-FAPI-04 outperformed [
18
F]FDG in detecting peritoneal (159 vs. 47,
P
< 0.001) and bone metastases (64 vs. 55,
P
= 0.003) by the lesion-based analysis. [
68
Ga]Ga-DOTA-FAPI-04 showed higher SUV
max
(10.3 vs. 8.1,
P
= 0.004) and TBR (11.6 vs. 5.8,
P
< 0.001) in primary tumor, and higher TBR in LN involvement (8.0 vs. 3.7,
P
< 0.001) and peritoneal metastases (8.1 vs. 3.2,
P
< 0.001), compared with [
18
F]FDG PET/CT. The specificity and positive predictive value of [
68
Ga]Ga-DOTA-FAPI-04 were significantly higher than that of [
18
F]FDG (100.0% vs. 97.7%,
P
< 0.001; 100.0% vs. 57.1%,
P
= 0.001) in determining the LN status. [
68
Ga]Ga-DOTA-FAPI-04 was comparable to [
18
F]FDG in evaluating N-staging (47.1% vs. 23.5%,
P
= 0.282). [
68
Ga]Ga-DOTA-FAPI-04 PET/CT detected more positive recurrent lesions in all restaging patients and showed clearer tumor delineation. Two patients underwent follow-up [
68
Ga]Ga-DOTA-FAPI-04 PET/CT scans after chemotherapy, which both showed remission.
Conclusions
[
68
Ga]Ga-DOTA-FAPI-04 PET/CT can better evaluate primary gastric cancer and metastatic lesions in the peritoneum, abdominal LNs, and bone. Furthermore, [
68
Ga]Ga-DOTA-FAPI-04 PET/CT provided more information for patients with recurrent disease and had the potential in monitoring response to treatment.