Details

Autor(en) / Beteiligte

• Zheng, Jieling
• Liu, Feng
• Lin, KaiXian
• Zhang, Li
• Huang, Nan
• Zheng, Wanjing
• Zhang, Jiaying
• Yao, Shaobo
• Miao, Weibing

Titel

[68Ga]Ga-FAPI PET/CT Improves the T Staging of Patients with Newly Diagnosed Nasopharyngeal Carcinoma: A Comparison with [18F]F-FDG

Ist Teil von

• Molecular imaging and biology, 2022-12, Vol.24 (6), p.973-985

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose This study aimed to explore the value of [ 68 Ga]Ga-labelled fibroblast activation protein inhibitor ([ 68 Ga]Ga-FAPI) positron emission tomography/computed tomography (PET/CT) in the initial staging of patients with newly diagnosed nasopharyngeal carcinoma (NPC), compared with 2-deoxy-2[ 18 F]fluoro-D-glucose ([ 18 F]F-FDG) PET/CT. Materials and Methods Forty-seven treatment-naïve patients with newly diagnosed NPC underwent magnetic resonance imaging (MRI), [ 68 Ga]Ga-DOTA-FAPI-04 PET/CT and [ 18 F]F-FDG PET/CT within 1 week. The diagnostic efficiency of all imaging modalities for evaluating primary tumour extension was compared from the two aspects of soft tissue and bony structure involvement. The accuracy of two PET/CT methods for diagnosing cervical lymph node (CLN) metastases was compared, and MRI served as the standard reference. T and N stages were assessed by MRI, [ 68 Ga]Ga-FAPI PET/CT and [ 18 F]F-FDG PET/CT. Immunohistochemical (IHC) staining for FAP was conducted in 22 of the patients. Results [ 68 Ga]Ga-FAPI PET/CT outperformed [ 18 F]F-FDG PET/CT in the assessment of primary tumour invasion in the cavernous sinus (10 vs. 1, p  < 0.001) and bony structures (207 vs. 177, p  < 0.001). Compared with MRI, [ 68 Ga]Ga-FAPI PET/CT upgraded and underestimated T stage in 13 and 2 patients, while [ 18 F]F-FDG PET/CT upgraded and underestimated T stage in 5 and 13 patients. However, [ 68 Ga]Ga-FAPI PET/CT was inferior to [ 18 F]F-FDG PET/CT in diagnosing positive CLNs based on the analyses of patients, neck sides, neck levels and individual nodes. [ 68 Ga]Ga-FAPI PET/CT changed therapeutic schedules in 8 patients because of stage group changes. The presence of FAP with high quantity and intensity in cancer-associated fibroblasts (CAFs) was confirmed in all tumour specimens. Conclusion [ 68 Ga]Ga-FAPI PET/CT outperformed [ 18 F]F-FDG PET/CT in detecting the cavernous sinus and bony structure involvement of primary NPC tumours, suggesting its value in improving T staging and therapeutic regimen selection. However, the performance of [ 68 Ga]Ga-FAPI PET/CT is less promising for N staging because it detected fewer positive CLNs than [ 18 F]F-FDG PET/CT.