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@ARTICLE{Rhrich:168701,
      author       = {M. Röhrich and M. Syed and D. P. Liew and F. L. Giesel$^*$
                      and J. Liermann and P. L. Choyke and A. K. Wefers$^*$ and T.
                      Ritz and M. Szymbara$^*$ and L. Schillings and U. Heger and
                      H. Rathke and C. Kratochwil and P. E. Huber$^*$ and A. von
                      Deimling$^*$ and J. Debus and H.-U. Kauczor and U.
                      Haberkorn$^*$ and S. Adeberg},
      title        = {68{G}a-{FAPI}-{PET}/{CT} improves diagnostic staging and
                      radiotherapy planning of {A}denoid {C}ystic {C}arcinomas -
                      imaging analysis and histological validation.},
      journal      = {Radiotherapy and oncology},
      volume       = {160},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2021-01009},
      pages        = {192-201},
      year         = {2021},
      note         = {2021 May 1;160:192-201},
      abstract     = {Adenoid cystic carcinomas (ACCs) are rare epithelial tumors
                      mostly situated in the head and neck region and
                      characterized by infiltrative growth. The tumor stroma of
                      ACCs includes cancer-associated fibroblasts (CAFs)
                      expressing Fibroblast Activation Protein (FAP), a new target
                      for positron emission tomography (PET) imaging. Here we
                      describe the value of PET/ computed tomography (PET/CT)
                      imaging using 68Ga-labelled FAP-Inhibitors
                      (68Ga-FAPI-PET/CT) and their clinical potential for staging
                      and radiotherapy planning in 12 ACC patients (7 primary, 5
                      recurrent).Patients underwent contrast enhanced staging CT
                      (ceCT) and magnetic resonance imaging (ceMRI) before
                      68Ga-FAPI - PET/CT. PET-scans were acquired 10, 60 and 180
                      minutes after administration of 150-250 MBq of 68Ga-labelled
                      FAPI tracers. SUVmax and SUVmean values of ACCs and healthy
                      organs were obtained using a $60\%$ of maximum iso-contour.
                      FAP and alpha smooth muscle actin (α-SMA)
                      immunohistochemistry was performed in 13 cases (3 with and
                      10 without 68Ga FAPI-PET/CT). Staging and radiotherapy
                      planning based on 68Ga-FAPI-PET/CT versus ceCT/MRI alone
                      were compared.We observed elevated tracer uptake in all
                      ACCs. Immunohistochemistry showed FAP-expressing CAFs in the
                      tumor. Compared to conventional staging, 68Ga-FAPI-PET/CT
                      led to upstaging in 2/12 patients and to detection of
                      additional metastases in 3 patients, thus in total $42\%$ of
                      patients had their staging altered. Moreover, 68Ga-FAPI PET
                      improved the accuracy of target volume delineation for
                      radiotherapy, as compared to CT and MRI.68Ga-FAPI-PET/CT is
                      a promising imaging modality for ACC, increasing the
                      accuracy of staging exams and radiotherapy planning volumes,
                      as compared conventional to CT and MRI.},
      keywords     = {ACC (Other) / Adenoid cystic carcinoma (Other) / FAP
                      (Other) / Fibroblast Activation Protein (Other) / Positron
                      Emission Tomography (Other) / Radiotherapy (Other) / Staging
                      (Other) / TNM (Other) / alpha SMA (Other)},
      cin          = {HD01 / B300 / E055 / E060},
      ddc          = {610},
      cid          = {I:(DE-He78)HD01-20160331 / I:(DE-He78)B300-20160331 /
                      I:(DE-He78)E055-20160331 / I:(DE-He78)E060-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33940087},
      doi          = {10.1016/j.radonc.2021.04.016},
      url          = {https://inrepo02.dkfz.de/record/168701},
}