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Comparison of 68 Ga-FAPI and 18 F-FDG Uptake in Gastric, Duodenal, and Colorectal Cancers.
- Source :
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Radiology [Radiology] 2021 Feb; Vol. 298 (2), pp. 393-402. Date of Electronic Publication: 2020 Dec 01. - Publication Year :
- 2021
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Abstract
- Background Accurate clinical staging is crucial to managing gastrointestinal cancer, but fluorine 18 ( <superscript>18</superscript> F) fluorodeoxyglucose (FDG) PET/CT has limitations. Targeting fibroblast-activation protein is a newer diagnostic approach for the visualization of tumor stroma, and gallium 68 ( <superscript>68</superscript> Ga)-labeled fibroblast-activation protein inhibitors (FAPIs), hereafter <superscript>68</superscript> Ga-FAPIs, present a promising alternative to <superscript>18</superscript> F-FDG. Purpose To compare the diagnostic efficacy of <superscript>68</superscript> Ga-FAPI PET/CT in primary and metastatic lesions of gastrointestinal malignancies with that of <superscript>18</superscript> F-FDG PET/CT. Materials and Methods Images from patients with gastric, duodenal, and colorectal cancers who underwent contemporaneous <superscript>18</superscript> F-FDG and <superscript>68</superscript> Ga-FAPI PET/CT between October 2019 through June 2020 were retrospectively analyzed. <superscript>18</superscript> F-FDG and <superscript>68</superscript> Ga-FAPI uptakes were compared by using the Wilcoxon signed-rank test. The McNemar test was used to compare the diagnostic performance between the two techniques. Results Thirty-five patients (median age, 64 years [interquartile range, 53-68 years]; 18 men) were evaluated. In treatment-naive patients ( n = 19), <superscript>68</superscript> Ga-FAPI PET/CT led to upstaging of the clinical TNM stage in four (21%) patients compared with <superscript>18</superscript> F-FDG PET/CT. Tracer uptake was higher with <superscript>68</superscript> Ga-FAPI PET/CT than with <superscript>18</superscript> F-FDG PET/CT in primary lesions (gastric cancer: 12.7 vs 3.7, respectively, P = .003; colorectal cancer: 15.9 vs 7.9, P = .03), involved lymph nodes (6.7 vs 2.4, P < .001), and bone and visceral metastases (liver metastases: 9.7 vs 5.2, P < .001; peritoneal metastases: 8.4 vs 3.6, P < .001; bone metastases: 4.3 vs 2.2, P < .001; lung metastases: 4.4 vs 1.9, P = .01). In addition, the sensitivity of <superscript>68</superscript> Ga-FAPI PET/CT was higher than that of <superscript>18</superscript> F-FDG PET/CT in the detection of primary tumors (100% [19 of 19] vs 53% [10 of 19], respectively; P = .004), lymph nodes (79% [22 of 28] vs 54% [15 of 28], P < .001), and bone and visceral metastases (89% [31 of 35] vs 57% [20 of 35], P < .001). Conclusion Gallium 68 fibroblast-activation protein inhibitor PET/CT was superior to fluorine 18 fluorodeoxyglucose PET/CT in the detection of primary and metastatic lesions in gastric, duodenal, and colorectal cancers, with higher tracer uptake in most primary and metastatic lesions. Published under a CC BY 4.0 license.
- Subjects :
- Aged
Female
Humans
Male
Middle Aged
Radiopharmaceuticals pharmacokinetics
Reproducibility of Results
Retrospective Studies
Colorectal Neoplasms diagnostic imaging
Duodenal Neoplasms diagnostic imaging
Fluorodeoxyglucose F18 pharmacokinetics
Positron Emission Tomography Computed Tomography methods
Quinolines pharmacokinetics
Stomach Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1527-1315
- Volume :
- 298
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 33258746
- Full Text :
- https://doi.org/10.1148/radiol.2020203275