[ 68  Ga]Ga-FAPI-46 PET/CT for locoregional lymph node staging in urothelial carcinoma of the bladder prior to cystectomy: initial experiences from a pilot analysis.

Autor: Unterrainer LM; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany. Lena.Unterrainer@med.uni-muenchen.de.; Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, USA. Lena.Unterrainer@med.uni-muenchen.de., Eismann L; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany., Lindner S; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Gildehaus FJ; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Toms J; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Casuscelli J; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany., Holzgreve A; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Kunte SC; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Cyran CC; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Menold P; Department of Urology, Krankenhaus Barmherzige Brüder, Munich, Germany., Karl A; Department of Urology, Krankenhaus Barmherzige Brüder, Munich, Germany., Unterrainer M; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.; Die RADIOLOGIE, Munich, Germany., Ledderose ST; Institute of Pathology, LMU Munich, Munich, Germany., Stief CG; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany., Bartenstein P; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany., Kretschmer A; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany.; Janssen Research and Development, Los Angeles, USA., Schulz GB; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2024 May; Vol. 51 (6), pp. 1786-1789. Date of Electronic Publication: 2024 Jan 18.
DOI: 10.1007/s00259-024-06595-z
Abstrakt: Introduction: [ 68  Ga]Ga-FAPI-46 PET/CT is a novel hybrid imaging method that previously showed additional diagnostic value in the assessment of distant urothelial carcinoma lesions. We hypothesized that patients with bladder cancer benefit from [ 68  Ga]Ga-FAPI-46 PET/CT prior to radical cystectomy for locoregional lymph node staging.
Materials and Methods: Eighteen patients underwent [ 68  Ga]Ga-FAPI-46 PET/CT for evaluation of lymph node (LN) status in predefined LN regions. Two hundred twenty-nine intraoperatively removed LN served as histopathological reference standard.
Results: Urothelial carcinoma (UC) spread was found in ten LN in seven different regions (14.3%). Hereby, [ 68  Ga]Ga-FAPI-46 PET/CT was positive in four out of seven regions (57.1%) and showed significantly increased FAPI uptake compared to non-pathological regions. In the remaining three out of seven (42.9%) regions, [ 68  Ga]Ga-FAPI-46 PET/CT was rated negative since no pathological increased FAPI uptake was detected or the proximity of the urinary tract prevented a differentiation from physiological uptake. CT was inconspicuous in these three regions. In total, two FAP-positive LN regions were found without histopathological counterpart. Overall, sensitivity, specificity, positive predictive value, and negative predictive value were 57.1%, 95.2%, 66.7%, and 93.0% for PET imaging.
Conclusion: In summary, this innovative [ 68  Ga]Ga-FAPI-46 PET/CT method showed high specificity and negative predictive value in patients with bladder UC with a future potential to optimize therapy planning.
(© 2024. The Author(s).)
Databáze: MEDLINE
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