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Objective: This study aimed to compare 18 FDGPET/CT in patients who develop bone metastases due to various cancers and to investigate the prognostic significance of the 68 FAPI-PET/CT SUVmax value for survival., Methods: Patients with bone metastases who underwent both 68  Ga-FAPI PET/CT and  18 FDGPET/CT within a 1 week period were included in this retrospective study. The effect of the SUVmax value of bone lesions on overall survival was analyzed., Results: A total of 75 eligible patients with 139 bone lesions were included in this study. The median age of the patients was 55 (30-83) and 48(64%) patients were newly diagnosed. The primary lesion median 68  Ga-FAPI PET/CT SUVmax value was higher than the median 18 FDGPET/CT SUVmax (10.75 versus 6.7). Bone lesions 68  Ga-FAPI PET/CT SUVmax median (IQR) were 7.8 (4.6-13.2), and 18 FDGPET/CT SUVmax of bone lesions were 5.9 (3.8-8.2). More bone lesions were detected on 68  Ga-FAPI PET/CT than on 18 FDGPET/CT(median IQR 4 [1-9] versus 2 [1-6] (p = 0.014). The extra lesions observed on 68  Ga-FAPI PET/CT were mostly sclerotic bone lesions (p = 0.001). 68  Ga-FAPI PET/CT SUVmax was significantly higher in vertebra and thorax lesions (p = 0.011 and p = 0.018, respectively). While the bone lesion 68  Ga-FAPI PET/CT SUVmax affected the OS, the 18 FDGPET/CT SUVmax value did not affect the OS (p < 0.001 and p = 0.079, respectively). In ROC analysis, a cut-off-off value of 68  Ga-FAPI PET/CT SUVmax > 7.7 was found for OS (AUC: 0.619). The median OS in the group above the cut-off value was worse than that in the group below the cut-off value (32 versus 45) months (p = 0.002). In the multivariate analysis for OS, the 68  Ga-FAPI PET/CT SUVmax of bone lesions was an important parameter, as well as cancer subtype, ALP level, and disease occurrence., Conclusions: 68  Ga-FAPI PET/CT detected more bone lesions and higher SUVmax values than 18 FDGPET/CT in various cancers. The prognostic value of the SUVmax value of 68  Ga-FAPI PET/CT bone lesions was observed regardless of disease subtype., (© 2024. The Author(s), under exclusive licence to The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)

Purpose: We compared the ability of 68 Ga-FAPI PET//CT with 18 FDG PET/CT imaging techniques to detect additional lesions in breast cancer patients that may affect further chemotherapy options., Methods: A total of 48 patients with breast cancer underwent concurrent 68 Ga-FAPI-04 and 18 FDG PET/CT regardless of whether they had received chemotherapy or not in the last month before imaging. Both modalities were compared according to various parameters: clinical/pathological features, number of lesions detected, activity uptake (SUV max ), and the effect on the evaluation of response to treatment in the post-chemotherapy group., Results: This retrospective study included 48 patients with breast cancer (mean age 53.3 ± 11.7 years; IDC 89.6%; ILC 10.4%). In the comparison of both modalities, no statistical significance was obtained in terms of the pathological characteristics of the patients. More lesions were demonstrated in all categorized regions in 68 Ga-FAPI PET/CT imaging with higher uptake values compared to 18 FDG PET/CT in this study. In the treatment response evaluation of the post-chemotherapy group, 12 cases (12/24) who were evaluated as PMR, CMR, or SD according to 18 FDG PET/CT results were later accepted as PD due to newly detected lesions in complementary 68 Ga-FAPI PET/CT imaging and treatment of patients was managed accordingly by clinicians., Conclusion: It was determined that 68 Ga-FAPI PET/CT was superior to 18 FDG PET/CT in terms of accuracy and it was thought that 68 Ga-FAPI PET/CT could be utilized as an additional complementary imaging to 18 FDG PET/CT. Moreover, 68 Ga-FAPI PET/CT, with its significant theranostic potential, could become a key element in predicting the pathological response of breast cancer patients in further researches., (© 2021. The Japanese Society of Nuclear Medicine.)