Science and Research

(68)Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer

The recent development of quinoline-based PET tracers that act as fibroblast-activation-protein inhibitors (FAPIs) demonstrated promising preclinical and clinical results. FAP is overexpressed by cancer-associated fibroblasts of several tumor entities. Here, we quantify the tumor uptake on (68)Ga-FAPI PET/CT of various primary and metastatic tumors to identify the most promising indications for future application. Methods: (68)Ga-FAPI PET/CT scans were requested by various referring physicians according to individual clinical indications that were considered insufficiently covered by (18)F-FDG PET/CT or other imaging modalities. All PET/CT was performed 1 h after injection of 122-312 MBq of (68)Ga-FAPI-04. We retrospectively identified 80 patients with histopathologically proven primary tumors or metastases or radiologically unequivocal metastatic lesions of histologically proven primary tumors. Tumor uptake was quantified by SUVmax and SUVmean (60% isocontour). Results: Eighty patients with 28 different tumor entities (54 primary tumors and 229 metastases) were evaluated. The highest average SUVmax (>12) was found in sarcoma, esophageal, breast, cholangiocarcinoma, and lung cancer. The lowest (68)Ga-FAPI uptake (average SUVmax < 6) was observed in pheochromocytoma, renal cell, differentiated thyroid, adenoid cystic, and gastric cancer. The average SUVmax of hepatocellular, colorectal, head-neck, ovarian, pancreatic, and prostate cancer was intermediate (SUV 6-12). SUV varied across and within all tumor entities. Because of low background in muscle and blood pool (SUVmax < 2), the tumor-to-background contrast ratios were more than 3-fold in the intermediate and more than 6-fold in the high-intensity uptake group. Conclusion: Several highly prevalent cancers presented with remarkably high uptake and image contrast on (68)Ga-FAPI PET/CT. The high and rather selective tumor uptake may open up new applications for noninvasive tumor characterization, staging examinations, or radioligand therapy.
  • Kratochwil, C.
  • Flechsig, P.
  • Lindner, T.
  • Abderrahim, L.
  • Altmann, A.
  • Mier, W.
  • Adeberg, S.
  • Rathke, H.
  • Rohrich, M.
  • Winter, H.
  • Plinkert, P. K.
  • Marme, F.
  • Lang, M.
  • Kauczor, H. U.
  • Jager, D.
  • Debus, J.
  • Haberkorn, U.
  • Giesel, F. L.

Keywords

  • Biological Transport
  • *Gallium Radioisotopes
  • Gelatinases/*antagonists & inhibitors
  • Humans
  • Membrane Proteins/*antagonists & inhibitors
  • Neoplasm Metastasis
  • Neoplasms/*diagnostic imaging/*metabolism
  • *Positron Emission Tomography Computed Tomography
  • Radioactive Tracers
  • Serine Endopeptidases
  • *fapi
  • *pet/ct
  • *breast cancer
  • *colorectal cancer
  • *lung cancer
Publication details
DOI: 10.2967/jnumed.119.227967
Journal: J Nucl Med
Pages: 801-805 
Number: 6
Work Type: Original
Location: TLRC
Disease Area: LC
Partner / Member: UKHD
Access-Number: 30954939
See publication on PubMed

DZL Engagements

chevron-down