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@ARTICLE{Glatting:180106,
      author       = {F. M. Glatting$^*$ and J. Hoppner and D. P. Liew and A. van
                      Genabith and A.-M. Spektor and L. Steinbach and A. Hubert
                      and C. Kratochwil and F. L. Giesel and K. Dendl and H.
                      Rathke and H.-U. Kauczor and P. E. Huber$^*$ and U. A.
                      Haberkorn$^*$ and M. Röhrich},
      title        = {{R}epetitive early {FAPI}-{PET} acquisition comparing
                      {FAPI}-02, {FAPI}-46 and {FAPI}-74: methodological and
                      diagnostic implications for malignant, inflammatory and
                      degenerative lesions.},
      journal      = {Journal of nuclear medicine},
      volume       = {63},
      number       = {12},
      issn         = {0161-5505},
      address      = {Reston, Va.},
      publisher    = {SNM},
      reportid     = {DKFZ-2022-01099},
      pages        = {1844-1851},
      year         = {2022},
      note         = {#EA:E055# / 2022 Dec;63(12):1844-1851},
      abstract     = {Purpose: FAPI-PET imaging targets FAP-positive, activated
                      fibroblasts and is a promising imaging technique for various
                      types of cancer and non-malignant pathologies. However, the
                      discrimination between malignant and non-malignant
                      FAPI-positive lesions based on static PET imaging with one
                      acquisition timepoint can be challenging. Additionally, the
                      optimal imaging timepoint for FAPI-PET has not been
                      identified yet and even different FAPI tracer variants are
                      currently used. In this retrospective analysis, we evaluate
                      the diagnostic value of repetitive early FAPI-PET-imaging
                      with FAPI-02, FAPI-46 and FAPI-74 for malignant,
                      inflammatory and degenerative lesions and describe
                      implications for future FAPI imaging protocols. Methods:
                      Whole-body PET-Scans of 24 cancer patients were acquired at
                      10, 22, 34, 46 and 58 minutes after the administration of
                      150-250 MBq of 68Ga-FAPI tracer molecules (8 Patients each
                      regarding FAPI-02, FAPI-46 and FAPI-74). Detection rates and
                      standardized uptake values (SUVmax and SUVmean) of healthy
                      tissues, cancer manifestations and non-malignant lesions
                      were measured and target-to-background ratios (TBR) versus
                      blood and fat were calculated for all acquisition
                      timepoints. Results: For most healthy tissues except fat and
                      spinal canal, biodistribution analysis showed decreasing
                      tracer uptake over time. 134 malignant,
                      inflammatory/reactive and degenerative lesions were
                      analysed. Detection rates were minimally reduced for the
                      first two acquisition timepoints and remained on a constant
                      high level from 34 to 58 minutes post injection (p.i.). The
                      uptake of all three tracer variants was higher in malignant
                      and inflammatory lesions than in degenerative lesions.
                      FAPI-46 showed the highest uptake and TBRs in all
                      pathologies. For all tracer variants, TBRs versus blood of
                      all pathologies constantly increased over time and TBRs
                      versus fat were constant or decreased slightly. Conclusion:
                      FAPI-PET/CT is a promising imaging modality for malignancies
                      and benign lesions. Repetitive early PET acquisition added
                      diagnostic value for the discrimination of malignant and
                      non-malignant FAPI-positive lesions. High detection rates
                      and TBRs over time confirm that PET acquisition at
                      timepoints earlier than 60 minutes p.i. deliver high
                      contrast images. Additionally, considering clinical
                      feasibility, acquisition at 30 to 40 min p.i. could be a
                      reasonable compromise. Different FAPI tracer variants show
                      significant differences in their time-dependent
                      biodistributional behaviour and should be selected carefully
                      depending on the clinical setting.},
      keywords     = {Biodistribution (Other) / Cancer (Other) / FAPI (Other) /
                      Fibroblast Activation Protein (Other) / Oncology: Pancreas
                      (Other) / PET (Other) / Radiotracer Tissue Kinetics (Other)},
      cin          = {E055 / E060},
      ddc          = {610},
      cid          = {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:35618480},
      doi          = {10.2967/jnumed.122.264069},
      url          = {https://inrepo02.dkfz.de/record/180106},
}