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European Radiology

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05-09-2023 | Metastasis | Chest

Head to head comparison of ⁶⁸Ga-DOTA-FAPI-04 vs ¹⁸F-FDG PET/CT in the evaluation of primary extrapulmonary tumors in the chest

Authors: Annan Zhang, Xiangxi Meng, Yuan Yao, Xin Zhou, Yan Zhang, Nan Li

Published in: European Radiology | Issue 3/2024

Abstract

Objective

We conducted a prospective study using ¹⁸F-flurodeoxyglucose (¹⁸F-FDG) and ⁶⁸Ga-DOTA-FAPI-04 (fibroblast-activation protein inhibitor, ⁶⁸Ga-FAPI) PET/CT to diagnose, differentiate, and stage primary extrapulmonary tumors of the thorax.

Methods

Fifty-four participants were undergoing ¹⁸F-FDG and ⁶⁸Ga-FAPI PET/CT and divided into the benign, intermediate, and malignant based on pathology. The maximum standardized uptake value (SUVmax), the tumor-to-blood pool ratio, and tumor-to-liver ratio were compared for primary tumors, lymph nodes, and metastases between the two modalities by two independent samples t tests. One-way ANOVA was used to compare the uptake of ¹⁸F-FDG or ⁶⁸Ga-FAPI among the three groups.

Results

Fifty-four participants were confirmed to have 71 primary lesions, 56 metastatic lymph nodes, and 43 metastatic lesions. ¹⁸F-FDG PET/CT could both effectively distinguish malignant lesions from non-malignant lesions, accuracies of 87.32% (p < 0.001). ⁶⁸Ga-FAPI PET/CT effectively differentiated benign lesions from the non-benign, accuracy being 91.55% (p < 0.001). The accuracies of ¹⁸F-FDG and ⁶⁸Ga-FAPI for detecting lymph node metastasis were 77.22% (61/79) and 87.34% (69/79) (p = 0.096). The uptake of ⁶⁸Ga-FAPI in metastatic lymph nodes was significantly higher than that of the nonmetastatic (p < 0.001). The detection rate of ⁶⁸Ga-FAPI PET/CT for metastatic lesions was significantly higher than that of ¹⁸F-FDG, 100% (43/43) vs. 53.49% (23/43) (p < 0.001). Compared with ¹⁸F-FDG PET/CT, ⁶⁸Ga-FAPI PET/CT changed the treatment strategy of 7.4% (4/54) participants.

Conclusion

⁶⁸Ga-FAPI PET/CT is valuable in the diagnosis and differentiation of primary extrapulmonary tumors and superior to ¹⁸F-FDG PET/CT for evaluating lymph node and distant metastasis.

Clinical relevance statement

The application of ⁶⁸Ga-FAPI PET/CT in primary extrapulmonary chest tumors is valuable, which is reflected in diagnosis, differentiation and exploration of lymph node metastasis and distant metastasis.

Key Points

• ⁶⁸Ga-FAPI PET/CT is valuable in the diagnosis, differentiation, and staging of primary extrapulmonary tumors.

• ⁶⁸Ga-FAPI PET/CT is superior to ¹⁸ F-FDG PET/CT for evaluating lymph node and distant metastasis.

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Title: Head to head comparison of 68Ga-DOTA-FAPI-04 vs 18F-FDG PET/CT in the evaluation of primary extrapulmonary tumors in the chest
Authors: Annan Zhang
Xiangxi Meng
Yuan Yao
Xin Zhou
Yan Zhang
Nan Li
Publication date: 05-09-2023
Publisher: Springer Berlin Heidelberg
Keyword: Metastasis
Published in: European Radiology / Issue 3/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10130-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Head to head comparison of ⁶⁸Ga-DOTA-FAPI-04 vs ¹⁸F-FDG PET/CT in the evaluation of primary extrapulmonary tumors in the chest

Abstract

Objective

Methods

Results

Conclusion

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Clinical relevance statement

Key Points

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