Head-to-Head Intra-Individual Comparison of Biodistribution and Tumor Uptake of [ 18 F]FAPI-74 with [ 18 F]FDG in Patients with PDAC: A Prospective Exploratory Study.

Autor: Novruzov E; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Giesel FL; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany.; Department of Nuclear Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany., Mori Y; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Choyke PL; Molecular Imaging Branch, National Cancer Institute, Bethesda, MD 20814, USA., Dabir M; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Mamlins E; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Schmitt D; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Antke C; Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany., Pinto C; Departamento Anatomia Patologica, Hospital Sotero del Rio, Santiago 8207257, Chile., Soza-Ried C; Center for Nuclear Medicine and PET/CT Positronmed, Santiago 7501068, Chile.; Positronpharma SA, Santiago 7501068, Chile., Fernandez R; Center for Nuclear Medicine and PET/CT Positronmed, Santiago 7501068, Chile., Amaral H; Center for Nuclear Medicine and PET/CT Positronmed, Santiago 7501068, Chile.; Positronpharma SA, Santiago 7501068, Chile., Kramer V; Center for Nuclear Medicine and PET/CT Positronmed, Santiago 7501068, Chile.; Positronpharma SA, Santiago 7501068, Chile., Badinez L; Instituto Radiooncológico Santiago INRAD, Santiago 7750000, Chile.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 May 17; Vol. 15 (10). Date of Electronic Publication: 2023 May 17.
DOI: 10.3390/cancers15102798
Abstrakt: Background: Radiolabeled fibroblast activation protein (FAP) ligands, a novel class of tracers for PET/CT imaging, have demonstrated very promising results in various oncological, as well as in some benign, diseases with long-term potential to supplant the current pan-cancer agent [ 18 F]FDG in some cancer types. Pancreatic ductal carcinoma (PDAC) belongs to the group of epithelial malignancies with a strong so-called "desmoplastic reaction", leading to a prominent tumor stroma with cancer-associated fibroblasts that exhibit a marked overexpression of fibroblast activation protein (FAP). The first clinical experiences in PDAC with 68 Ga-labeled FAP ligands suggested superior sensitivity to [ 18 F]FDG. However, there is limited data with 18 F-labeled FAP derivatives, i.e. [ 18 F]FAPI-74, yet prospective single- and multicenter trials are already ongoing. In this proof-of-concept study, we sought to evaluate the biodistribution, tumor uptake, and lesion detectability in patients with PDAC using [ 18 F]FAPI-74 PET/CT as compared to [ 18 F]FDG PET/CT scans for staging.
Methods: This study includes 7 patients (median age 69) who underwent both [ 18 F]FDG PET/CT with contrast-enhancement and [ 18 F]FAPI-74 PET with low-dose CT for primary staging (n = 3) and therapy response control after neoadjuvant (n = 1) or re-staging after palliative therapy (n = 3). The mean interval between PET scans was 11 ± 4 days (range 1-15 days). The [ 18 F]FDG and [ 18 F]FAPI-74 PET/CT scans were acquired at 64 ± 4.1 min (range 61-91 min) and 66.4 ± 6.3 min (range 60-76 min), respectively, after administration of 200 ± 94 MBq (range 79-318 MBq) and 235 ± 88 MBq (range 90-321 MBq), respectively. Quantification of tracer uptake was determined with SUV max and SUV mean . Furthermore, the tumor-to-background ratio (TBR) was derived by dividing the SUV max of tumor lesions by the SUV max of adipose tissue, skeletal muscle, and blood pool.
Results: Overall, 32 lesions were detected in 7 patients including primary (n = 7), lung (n = 7), bone (n = 3), lymph node (n = 13), and peritoneal metastases (n = 2). [ 18 F]FAPI-74 detected 22% more lesions compared with [ 18 F]FDG with a better TBR and visual lesion delineation. In one patient the primary lesion could be detected unequivocally with [ 18 F]FAPI-74 but was missed by [ 18 F]FDG imaging. Altogether, most of the lesions demonstrated markedly elevated uptake of [ 18 F]FAPI-74 with a simultaneous lower uptake in the background, providing a very high visual contrast.
Conclusion: To the best of our knowledge, this is the first, prospective, intra-individual investigation comparing [ 18 F]FAPI-74 with [ 18 F]FDG imaging in PDAC with encouraging results. These pivotalresults supporta larger, multicentric, prospective study to determine the value of [ 18 F]FAPI-74 in detecting and staging PDAC in comparison with current standard of care imaging.
Databáze: MEDLINE
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