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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-01-2022 | Peritoneal Cancer | Original Article

Head-to-head comparison of [⁶⁸Ga]Ga-FAPI-04 and [¹⁸F]-FDG PET/CT in evaluating the extent of disease in gastric adenocarcinoma

Authors: Jonathan Kuten, Charles Levine, Ofer Shamni, Sharon Pelles, Ido Wolf, Guy Lahat, Eyal Mishani, Einat Even-Sapir

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2022

Abstract

Background

[¹⁸F]-Fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) may sometimes be suboptimal for imaging gastric adenocarcinoma. The recently introduced [⁶⁸Ga]Ga-FAPI-04 (FAPI) PET/CT targets tumor stroma and has shown considerable potential in evaluating the extent of disease in a variety of tumors.

Methods

We performed a head-to-head prospective comparison of FAPI and FDG PET/CT in the same group of 13 patients with gastric adenocarcinoma who presented for either initial staging (n = 10) or restaging (n = 3) of disease. Lesion detection and maximum standardized uptake value (SUV_max) were compared between the two types of radiotracers.

Results

All ten primary gastric tumors were FAPI-positive (100% detection rate), whereas only five were also FDG-positive (50%). SUV_max was not significantly different, but the tumor-to-background ratio was higher for FAPI (mean, median, and range of 4.5, 3.2, and 0.8–9.7 for FDG and 12.9, 11.9, and 2.2–23.9 for FAPI, P = 0.007). The level of detection of regional lymph node involvement was comparable. FAPI showed a superior detection rate for peritoneal carcinomatosis (100% vs. none). Two patients with widespread peritoneal carcinomatosis underwent a follow-up FAPI scan after chemotherapy: one showed partial remission and the other showed progressive disease.

Conclusions

The findings of this pilot study suggest that FAPI PET/CT outperforms FDG PET/CT in detecting both primary gastric adenocarcinoma and peritoneal carcinomatosis from gastric cancer. FAPI PET/CT also shows promise for monitoring response to treatment in patients with peritoneal carcinomatosis from gastric cancer; however, larger trials are needed to validate these preliminary findings.

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Title: Head-to-head comparison of [68Ga]Ga-FAPI-04 and [18F]-FDG PET/CT in evaluating the extent of disease in gastric adenocarcinoma
Authors: Jonathan Kuten
Charles Levine
Ofer Shamni
Sharon Pelles
Ido Wolf
Guy Lahat
Eyal Mishani
Einat Even-Sapir
Publication date: 01-01-2022
Publisher: Springer Berlin Heidelberg
Keywords: Peritoneal Cancer
Peritoneal Carcinomatosis
Gastric Cancer
Gastric Cancer
Cytostatic Therapy
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2022
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05494-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Head-to-head comparison of [⁶⁸Ga]Ga-FAPI-04 and [¹⁸F]-FDG PET/CT in evaluating the extent of disease in gastric adenocarcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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