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European Journal of Nuclear Medicine and Molecular Imaging

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01-10-2021 | Magnetic Resonance Imaging | Original Article

Clinical utility of [⁶⁸Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma

Authors: Liang Zhao, Yizhen Pang, Hua Zheng, Chengkun Han, Jianwei Gu, Long Sun, Hua Wu, Sangang Wu, Qin Lin, Haojun Chen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2021

Abstract

Purpose

This study aimed to explore the clinical utility of [⁶⁸Ga]Ga-labeled fibroblast activation protein inhibitor ([⁶⁸Ga]Ga-FAPI) positron emission tomography/computed tomography (PET/CT) relative to [¹⁸F]-fluorodeoxyglucose ([¹⁸F]FDG) PET/CT and magnetic resonance imaging (MRI) for primary staging and recurrence detection in nasopharyngeal carcinoma (NPC).

Methods

This retrospective analysis utilized a sub-cohort of patients from a previously acquired database. Patients with NPC who underwent [¹⁸F]FDG and [⁶⁸Ga]Ga-FAPI PET/CT between October 2019 and November 2020 were included. The radiotracer uptake and clinical staging/restaging performances of [¹⁸F]FDG and [⁶⁸Ga]Ga-FAPI PET/CT were compared.

Results

Forty-five participants (39 for initial assessment, 6 for recurrence detection) were included. In treatment-naïve participants, [⁶⁸Ga]Ga-FAPI PET/CT showed higher radiotracer uptake than [¹⁸F]FDG PET/CT in primary tumors (16.18 vs. 10.11, P < 0.001), regional lymph nodes (11.42 vs. 7.37, P < 0.001), and bone and visceral metastases (6.94 vs. 3.11, P < 0.001). Compared with the [¹⁸F]FDG-based TNM stage, the [⁶⁸Ga]Ga-FAPI-based TNM stage was upgraded in ten patients (26%), resulting in management changes in seven patients (18%). Compared with MRI, [⁶⁸Ga]Ga-FAPI PET/CT upgraded and underestimated the T stage in four and two patients, respectively. In post-treatment patients, [⁶⁸Ga]Ga-FAPI PET/CT yielded more true-positive findings than [¹⁸F]FDG PET/CT in detecting local recurrence.

Conclusion

[⁶⁸Ga]Ga-FAPI PET/CT is a promising imaging modality for the diagnosis of primary and metastatic NPC. The exact tumor geographic imaging obtained through [⁶⁸Ga]Ga-FAPI PET/CT may be a supplement to MRI for T staging and radiotherapy planning.

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Title: Clinical utility of [68Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma
Authors: Liang Zhao
Yizhen Pang
Hua Zheng
Chengkun Han
Jianwei Gu
Long Sun
Hua Wu
Sangang Wu
Qin Lin
Haojun Chen
Publication date: 01-10-2021
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Metastasis
Computed Tomography
Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2021
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05336-w

At a glance: The STEP trials

Springer Medicine

Clinical utility of [⁶⁸Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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