Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2023

Open Access 10-12-2022 | Thyroid Cancer | Original Article

[18F]FAPI-42 PET/CT in differentiated thyroid cancer: diagnostic performance, uptake values, and comparison with 2-[18F]FDG PET/CT

Authors: Xingyu Mu, Xiaoxue Huang, Zewen Jiang, Meng Li, Lulu Jia, Zhongyuan Lv, Wei Fu, Jingsong Mao

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2023

Login to get access

Abstract

Purpose

This study aimed to assess the diagnostic performance of [18F]FAPI-42 PET/CT and compare it with that of 2-[18F]FDG PET/CT in patients with differentiated thyroid cancer (DTC) with biochemical elevations in Tg or anti-Tg antibodies.

Methods

A total of 42 patients with DTC with biochemical elevations in Tg or anti-Tg antibodies underwent [18F]FAPI-42 PET/CT as part of this study; of which, 11 additionally underwent 2-[18F]FDG PET/CT within 7 days. Images were semi-quantitatively and visually interpreted, and the quantity, location, and uptake values of lesions were noted. The diagnostic capacity of [18F]FAPI-42 PET/CT and biomarkers affecting the uptake of [18F]FAPI-42 were evaluated. In addition, the diagnostic performance and uptake of [18F]FAPI-42 and 2-[18F]FDG were compared, and the correlation between lesion diameter and quantitative parameters was investigated.

Results

A total of 161 lesions were detected in 27 (64%) patients on [18F]FAPI-42 PET/CT. FAPI-positive local recurrence showed the highest uptake intensity, followed by lymphatic, other site-associated (bone and pleura), and pulmonary lesions (mean SUVmax, 4.7 versus 3.7 versus 3.0 versus 2.2, respectively; P < 0.0001). The levels of TSH, Tg, and Tg-Ab did not affect the uptake value of lesions (median SUVmax: 2.4 versus 3.2, P = 0.56; 2.9 versus 2.4, P = 0.0935; 2.8 versus 2.6, P = 0.0525, respectively). A total of 90 positive lesions were detected in 7 patients using both modalities. All positive lesions showed statistically higher uptake of 2-[18F]FDG than that of [18F]FAPI-42 (SUVmax, 2.6 versus 2.1; P = 0.026). However, the SUVmax of [18F]FAPI-42 was higher than that of 2-[18F]FDG in local recurrences and lymphatic lesions (SUVmax, 4.2 versus 2.9 and 3.9 versus 3.4, respectively; P > 0.05).

Conclusion

[18F]FAPI-42 can be used for detecting lesions and reflecting FAP expression during local recurrence and metastasis in patients with DTC with biochemical elevations in Tg or anti-Tg antibodies. The diagnostic performance of [18F]FAPI-42 PET/CT is comparable with that of 2-[18F]FDG PET/CT in such patients.
Appendix
Available only for authorised users
Literature
4.
go back to reference Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. https://doi.org/10.1089/thy.2015.0020.CrossRefPubMedPubMedCentral Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. https://​doi.​org/​10.​1089/​thy.​2015.​0020.CrossRefPubMedPubMedCentral
10.
go back to reference Giesel FL, Kratochwil C, Lindner T, Marschalek MM, Loktev A, Lehnert W, et al. 68 Ga-FAPI PET/CT: biodistribution and preliminary dosimetry estimate of 2 DOTA-containing FAP-targeting agents in patients with various cancers. J Nucl Med. 2019;60:386–92.CrossRefPubMedPubMedCentral Giesel FL, Kratochwil C, Lindner T, Marschalek MM, Loktev A, Lehnert W, et al. 68 Ga-FAPI PET/CT: biodistribution and preliminary dosimetry estimate of 2 DOTA-containing FAP-targeting agents in patients with various cancers. J Nucl Med. 2019;60:386–92.CrossRefPubMedPubMedCentral
22.
go back to reference Maisto C, Aurilio M, Morisco A, de Marino R, Buonanno Recchimuzzo MJ, Carideo L, et al. Analysis of pros and cons in using [(68)Ga]Ga-PSMA-11 and [(18)F]PSMA-1007: production, costs, and PET/CT applications in patients with prostate cancer. Molecules (Basel, Switzerland). 2022:27. https://doi.org/10.3390/molecules27123862. Maisto C, Aurilio M, Morisco A, de Marino R, Buonanno Recchimuzzo MJ, Carideo L, et al. Analysis of pros and cons in using [(68)Ga]Ga-PSMA-11 and [(18)F]PSMA-1007: production, costs, and PET/CT applications in patients with prostate cancer. Molecules (Basel, Switzerland). 2022:27. https://​doi.​org/​10.​3390/​molecules2712386​2.
Metadata
Title
[18F]FAPI-42 PET/CT in differentiated thyroid cancer: diagnostic performance, uptake values, and comparison with 2-[18F]FDG PET/CT
Authors
Xingyu Mu
Xiaoxue Huang
Zewen Jiang
Meng Li
Lulu Jia
Zhongyuan Lv
Wei Fu
Jingsong Mao
Publication date
10-12-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2023
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-022-06067-2

Other articles of this Issue 4/2023

European Journal of Nuclear Medicine and Molecular Imaging 4/2023 Go to the issue