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Erschienen in: European Radiology 7/2023

21.02.2023 | Nuclear Medicine

The added value of [68Ga]Ga-DOTA-FAPI-04 PET/CT in pancreatic cancer: a comparison to [18F]F-FDG

verfasst von: Qiufang Liu, Si Shi, Shuai Liu, Xiaoping Xu, Silong Hu, Ji Zhang, Chunmei Wang, Xianjun Yu, Shaoli Song

Erschienen in: European Radiology | Ausgabe 7/2023

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Abstract

Objectives

We aimed to compare the diagnostic and prognostic performance of [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT in pancreatic cancer.

Methods

This single-center retrospective study enrolled 51 patients who underwent [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT. The final diagnosis on PET/CT images was verified by histopathology or 1-year follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT were calculated to compare the diagnostic efficacy. Progression-free survival (PFS) was the endpoint for the survival analysis. Twenty-six patients were eligible for the Kaplan–Meier survival analysis using a log-rank test. And multivariate analysis including age, sex, stage, CA199 level, and SUVmax of [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 was also performed. Two-tailed p < 0.05 was considered statistically significant.

Results

[68Ga]Ga-DOTA-FAPI-04 showed a higher sensitivity than [18F]FDG for detecting primary tumor (100% vs. 95.0%), metastatic lymph nodes (96.2% vs. 61.5%), and distant metastases (100% vs. 84.0%) (p < 0.0001, respectively). For [68Ga]Ga-DOTA-FAPI-04, the tumor-to-liver background ratio (TLBR) of liver metastases was higher (5.7 ± 3.2 vs. 3.2 ± 1.3, p < 0.0001). Furthermore, SUVmax > 14.9 on [68Ga]Ga-DOTA-FAPI-04 was significantly associated with PFS rates (chi-square = 12.05, p = 0.001). The Cox regression analysis showed that SUVmax of [68Ga]Ga-DOTA-FAPI-04 was an independent prognostic factor for PFS (p = 0.001; hazard ratio, 8.877).

Conclusions

[68Ga]Ga-DOTA-FAPI-04 PET/CT showed a higher sensitivity and accuracy than [18F]FDG PET/CT in diagnosing pancreatic cancer and might have an independent prognostic value for pancreatic cancer patients.

Key Points

[68Ga]Ga-DOTA-FAPI-04 PET/CT had a higher sensitivity and accuracy in detecting primary tumors, metastatic lymph nodes, and distant metastases than [18F]FDG PET/CT.
• SUVmax > 14.9 on [68Ga]Ga-DOTA-FAPI-04 PET/CT before chemotherapy was significantly associated with progress-free status rates (chi-square = 12.05, p = 0.001) in pancreatic cancer patients.
Literatur
1.
Zurück zum Zitat Tempero MA (2019) NCCN guidelines updates: pancreatic cancer. J Natl Compr Canc Netw 17:603–605PubMed Tempero MA (2019) NCCN guidelines updates: pancreatic cancer. J Natl Compr Canc Netw 17:603–605PubMed
2.
Zurück zum Zitat Arnold M, Rutherford MJ, Bardot A et al (2019) Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 20:1493–1505CrossRefPubMedPubMedCentral Arnold M, Rutherford MJ, Bardot A et al (2019) Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 20:1493–1505CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Scialpi M, Reginelli A, D’Andrea A et al (2016) Pancreatic tumors imaging: an update. Int J Surg 1:S142-155CrossRef Scialpi M, Reginelli A, D’Andrea A et al (2016) Pancreatic tumors imaging: an update. Int J Surg 1:S142-155CrossRef
5.
Zurück zum Zitat Daamen LA, Groot VP, Goense L et al (2018) The diagnostic performance of CT versus FDG PET-CT for the detection of recurrent pancreatic cancer: a systematic review and meta-analysis. Eur J Radiol 106:128–136CrossRefPubMed Daamen LA, Groot VP, Goense L et al (2018) The diagnostic performance of CT versus FDG PET-CT for the detection of recurrent pancreatic cancer: a systematic review and meta-analysis. Eur J Radiol 106:128–136CrossRefPubMed
6.
Zurück zum Zitat Wartski M, Sauvanet A (2019) 18F-FDG PET/CT in pancreatic adenocarcinoma: a role at initial imaging staging? Diagn Interv Imaging 100:735–741CrossRefPubMed Wartski M, Sauvanet A (2019) 18F-FDG PET/CT in pancreatic adenocarcinoma: a role at initial imaging staging? Diagn Interv Imaging 100:735–741CrossRefPubMed
7.
Zurück zum Zitat Biffi G, Tuveson DA (2021) Diversity and biology of cancer-associated fibroblasts. Physiol Rev 101:147–176CrossRefPubMed Biffi G, Tuveson DA (2021) Diversity and biology of cancer-associated fibroblasts. Physiol Rev 101:147–176CrossRefPubMed
9.
10.
Zurück zum Zitat Chen H, Pang Y, Li J et al (2022) Comparison of [(68)Ga]Ga-FAPI and [(18)F]FDG uptake in patients with gastric signet-ring-cell carcinoma: a multicenter retrospective study. Eur Radiol 33:1329–1341CrossRefPubMed Chen H, Pang Y, Li J et al (2022) Comparison of [(68)Ga]Ga-FAPI and [(18)F]FDG uptake in patients with gastric signet-ring-cell carcinoma: a multicenter retrospective study. Eur Radiol 33:1329–1341CrossRefPubMed
11.
Zurück zum Zitat Chen S, Chen Z, Zou G et al (2022) Accurate preoperative staging with [(68)Ga]Ga-FAPI PET/CT for patients with oral squamous cell carcinoma: a comparison to 2-[(18)F]FDG PET/CT. Eur Radiol 32:6070–6079CrossRefPubMed Chen S, Chen Z, Zou G et al (2022) Accurate preoperative staging with [(68)Ga]Ga-FAPI PET/CT for patients with oral squamous cell carcinoma: a comparison to 2-[(18)F]FDG PET/CT. Eur Radiol 32:6070–6079CrossRefPubMed
12.
Zurück zum Zitat Coto-Llerena M, Ercan C, Kancherla V et al (2020) High expression of FAP in colorectal cancer is associated with angiogenesis and immunoregulation processes. Front Oncol 10:979CrossRefPubMedPubMedCentral Coto-Llerena M, Ercan C, Kancherla V et al (2020) High expression of FAP in colorectal cancer is associated with angiogenesis and immunoregulation processes. Front Oncol 10:979CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Hessmann E, Buchholz SM, Demir IE et al (2020) Microenvironmental determinants of pancreatic cancer. Physiol Rev 100:1707–1751CrossRefPubMed Hessmann E, Buchholz SM, Demir IE et al (2020) Microenvironmental determinants of pancreatic cancer. Physiol Rev 100:1707–1751CrossRefPubMed
14.
Zurück zum Zitat Elyada E, Bolisetty M, Laise P et al (2019) Cross-species single-cell analysis of pancreatic ductal adenocarcinoma reveals antigen-presenting cancer-associated fibroblasts. Cancer Discov 9:1102–1123CrossRefPubMedPubMedCentral Elyada E, Bolisetty M, Laise P et al (2019) Cross-species single-cell analysis of pancreatic ductal adenocarcinoma reveals antigen-presenting cancer-associated fibroblasts. Cancer Discov 9:1102–1123CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Yin Z, Dong C, Jiang K et al (2019) Heterogeneity of cancer-associated fibroblasts and roles in the progression, prognosis, and therapy of hepatocellular carcinoma. J Hematol Oncol 12:1–9CrossRef Yin Z, Dong C, Jiang K et al (2019) Heterogeneity of cancer-associated fibroblasts and roles in the progression, prognosis, and therapy of hepatocellular carcinoma. J Hematol Oncol 12:1–9CrossRef
16.
Zurück zum Zitat Röhrich M, Naumann P, Giesel FL et al (2020) Impact of (68)Ga-FAPI-PET/CT imaging on the therapeutic management of primary and recurrent pancreatic ductal adenocarcinomas. J Nucl Med 62:779–786CrossRefPubMed Röhrich M, Naumann P, Giesel FL et al (2020) Impact of (68)Ga-FAPI-PET/CT imaging on the therapeutic management of primary and recurrent pancreatic ductal adenocarcinomas. J Nucl Med 62:779–786CrossRefPubMed
17.
Zurück zum Zitat Zhang Z, Jia G, Pan G et al (2022) Comparison of the diagnostic efficacy of (68) Ga-FAPI-04 PET/MR and (18)F-FDG PET/CT in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging 49:2877–2888CrossRefPubMed Zhang Z, Jia G, Pan G et al (2022) Comparison of the diagnostic efficacy of (68) Ga-FAPI-04 PET/MR and (18)F-FDG PET/CT in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging 49:2877–2888CrossRefPubMed
18.
Zurück zum Zitat Xu D, Wang J, Liu T et al (2021) Quantitative definitions of pain, CA19-9, and tumor size as high-risk features of resectable pancreatic cancer: a single-center retrospective cohort study. Gland Surg 10:770–779CrossRefPubMedPubMedCentral Xu D, Wang J, Liu T et al (2021) Quantitative definitions of pain, CA19-9, and tumor size as high-risk features of resectable pancreatic cancer: a single-center retrospective cohort study. Gland Surg 10:770–779CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Wu Z, Zhao P, Wang Z et al (2022) Adjusting CA19-9 values with clinical stage and bilirubin to better predict survival of resectable pancreatic cancer patients: 5-year-follow-up of a single center. Front Oncol 12 Wu Z, Zhao P, Wang Z et al (2022) Adjusting CA19-9 values with clinical stage and bilirubin to better predict survival of resectable pancreatic cancer patients: 5-year-follow-up of a single center. Front Oncol 12
20.
Zurück zum Zitat Pang Y, Zhao L (2021) Comparison of (68)Ga-FAPI and (18)F-FDG uptake in gastric, duodenal, and colorectal cancers. Radiology 298:393–402CrossRefPubMed Pang Y, Zhao L (2021) Comparison of (68)Ga-FAPI and (18)F-FDG uptake in gastric, duodenal, and colorectal cancers. Radiology 298:393–402CrossRefPubMed
21.
Zurück zum Zitat Fan C, Guo W, Su G et al (2021) widespread metastatic gastric signet-ring cell carcinoma shown by 68Ga-FAPI PET/CT. Clin Nucl Med 46:e78–e79CrossRefPubMed Fan C, Guo W, Su G et al (2021) widespread metastatic gastric signet-ring cell carcinoma shown by 68Ga-FAPI PET/CT. Clin Nucl Med 46:e78–e79CrossRefPubMed
22.
Zurück zum Zitat Guo W, Pang Y, Yao L et al (2020) Imaging fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [(68)Ga]Ga-FAPI-04 PET/CT versus MRI and [(18)F]-FDG PET/CT. Eur J Nucl Med Mol Imaging 48:1604–1617CrossRefPubMed Guo W, Pang Y, Yao L et al (2020) Imaging fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [(68)Ga]Ga-FAPI-04 PET/CT versus MRI and [(18)F]-FDG PET/CT. Eur J Nucl Med Mol Imaging 48:1604–1617CrossRefPubMed
23.
Zurück zum Zitat Pang Y, Zhao L, Shang Q et al (2021) Positron emission tomography and computed tomography with [(68)Ga]Ga-fibroblast activation protein inhibitors improves tumor detection and staging in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging 49:1322–1337CrossRefPubMed Pang Y, Zhao L, Shang Q et al (2021) Positron emission tomography and computed tomography with [(68)Ga]Ga-fibroblast activation protein inhibitors improves tumor detection and staging in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging 49:1322–1337CrossRefPubMed
24.
Zurück zum Zitat Sandberg TP, Stuart M, Oosting J et al (2019) Increased expression of cancer-associated fibroblast markers at the invasive front and its association with tumor-stroma ratio in colorectal cancer. BMC Cancer 19:284CrossRefPubMedPubMedCentral Sandberg TP, Stuart M, Oosting J et al (2019) Increased expression of cancer-associated fibroblast markers at the invasive front and its association with tumor-stroma ratio in colorectal cancer. BMC Cancer 19:284CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Liao Y, Ni Y, He R et al (2013) Clinical implications of fibroblast activation protein-α in non-small cell lung cancer after curative resection: a new predictor for prognosis. J Cancer Res Clin Oncol 139:1523–1528CrossRefPubMed Liao Y, Ni Y, He R et al (2013) Clinical implications of fibroblast activation protein-α in non-small cell lung cancer after curative resection: a new predictor for prognosis. J Cancer Res Clin Oncol 139:1523–1528CrossRefPubMed
26.
Zurück zum Zitat Lo A, Li CP, Buza EL et al (2017) Fibroblast activation protein augments progression and metastasis of pancreatic ductal adenocarcinoma. JCI Insight 2:e92232CrossRefPubMedPubMedCentral Lo A, Li CP, Buza EL et al (2017) Fibroblast activation protein augments progression and metastasis of pancreatic ductal adenocarcinoma. JCI Insight 2:e92232CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Mao X, Xu J, Wang W et al (2021) Crosstalk between cancer-associated fibroblasts and immune cells in the tumor microenvironment: new findings and future perspectives. Mol Cancer 20:131CrossRefPubMedPubMedCentral Mao X, Xu J, Wang W et al (2021) Crosstalk between cancer-associated fibroblasts and immune cells in the tumor microenvironment: new findings and future perspectives. Mol Cancer 20:131CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Altmann A, Haberkorn U, Siveke J (2021) The latest developments in imaging of fibroblast activation protein. J Nucl Med 62:160–167CrossRefPubMed Altmann A, Haberkorn U, Siveke J (2021) The latest developments in imaging of fibroblast activation protein. J Nucl Med 62:160–167CrossRefPubMed
29.
Zurück zum Zitat Luo Y, Pan Q, Zhang W et al (2020) Intense FAPI uptake in inflammation may mask the tumor activity of pancreatic cancer in 68Ga-FAPI PET/CT. Clin Nucl Med 45:310–311CrossRefPubMed Luo Y, Pan Q, Zhang W et al (2020) Intense FAPI uptake in inflammation may mask the tumor activity of pancreatic cancer in 68Ga-FAPI PET/CT. Clin Nucl Med 45:310–311CrossRefPubMed
30.
Zurück zum Zitat Bulle A, Lim KH (2020) Beyond just a tight fortress: contribution of stroma to epithelial-mesenchymal transition in pancreatic cancer. Signal Transduct Target Ther 5:1–12 Bulle A, Lim KH (2020) Beyond just a tight fortress: contribution of stroma to epithelial-mesenchymal transition in pancreatic cancer. Signal Transduct Target Ther 5:1–12
31.
Zurück zum Zitat Ogawa Y, Masugi Y (2021) Three distinct stroma types in human pancreatic cancer identified by image analysis of fibroblast subpopulations and collagen. Clin Cancer Res 27:107–119CrossRefPubMed Ogawa Y, Masugi Y (2021) Three distinct stroma types in human pancreatic cancer identified by image analysis of fibroblast subpopulations and collagen. Clin Cancer Res 27:107–119CrossRefPubMed
32.
Zurück zum Zitat Saluja A, Maitra A (2019) Pancreatitis and pancreatic cancer. Gastroenterology 156:1937–1940CrossRefPubMed Saluja A, Maitra A (2019) Pancreatitis and pancreatic cancer. Gastroenterology 156:1937–1940CrossRefPubMed
Metadaten
Titel
The added value of [68Ga]Ga-DOTA-FAPI-04 PET/CT in pancreatic cancer: a comparison to [18F]F-FDG
verfasst von
Qiufang Liu
Si Shi
Shuai Liu
Xiaoping Xu
Silong Hu
Ji Zhang
Chunmei Wang
Xianjun Yu
Shaoli Song
Publikationsdatum
21.02.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 7/2023
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-09445-y

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