%0 Journal Article
%A Pabst, Kim M
%A Trajkovic-Arsic, Marija
%A Cheung, Phyllis F Y
%A Ballke, Simone
%A Steiger, Katja
%A Bartel, Timo
%A Schaarschmidt, Benedikt M
%A Milosevic, Aleksandar
%A Seifert, Robert
%A Nader, Michael
%A Kessler, Lukas
%A Siveke, Jens
%A Lueckerath, Katharina
%A Kasper, Stefan
%A Herrmann, Ken
%A Hirmas, Nader
%A Schmidt, Hartmut H
%A Hamacher, Rainer
%A Fendler, Wolfgang P
%T Superior Tumor Detection for 68Ga-FAPI-46 Versus 18F-FDG PET/CT and Conventional CT in Patients with Cholangiocarcinoma.
%J Journal of nuclear medicine
%V 64
%N 7
%@ 0097-9058
%C New York, NY
%I Soc.
%M DKFZ-2023-00718
%P 1049-1055
%D 2023
%Z 2023 Jul;64(7):1049-1055
%X Management of cholangiocarcinoma is among other factors critically determined by accurate staging. Here, we aimed to assess the accuracy of PET/CT with the novel cancer fibroblast-directed 68Gafibroblast activation protein (FAP) inhibitor (FAPI)-46 tracer for cholangiocarcinoma staging and management guidance. Methods: Patients with cholangiocarcinoma from a prospective observational trial were analyzed. 68Ga-FAPI-46 PET/CT detection efficacy was compared with 18F-FDG PET/CT and conventional CT. SUVmax/tumor-to-background ratio (Wilcoxon test) and separately uptake for tumor grade and location (Mann-Whitney U test) were compared. Immunohistochemical FAP and glucose transporter 1 (GLUT1) expression of stromal and cancer cells was analyzed. The impact on therapy management was investigated by pre- and post-PET/CT questionnaires sent to the treating physicians. Results: In total, 10 patients (6 with intrahepatic cholangiocarcinoma and 4 with extrahepatic cholangiocarcinoma; 6 with grade 2 tumor and 4 with grade 3 tumor) underwent 68Ga-FAPI-46 PET/CT and conventional CT; 9 patients underwent additional 18F-FDG PET/CT. Immunohistochemical analysis was performed on the entire central tumor plain in 6 patients. Completed questionnaires were returned in 8 cases. Detection rates for 68Ga- FAPI-46 PET/CT, 18F-FDG PET/CT, and CT were 5, 5, and 5, respectively, for primary tumor; 11, 10, and 3, respectively, for lymph nodes; and 6, 4, and 2, respectively, for distant metastases. 68Ga-FAPI-46 versus 18F-FDG PET/CT SUVmax for primary tumor, lymph nodes, and distant metastases was 14.5 versus 5.2 (P = 0.043), 4.7 versus 6.7 (P = 0.05), and 9.5 versus 5.3 (P = 0.046), respectively, and tumor-to-background ratio (liver) was 12.1 versus 1.9 (P = 0.043) for primary tumor. Grade 3 tumors demonstrated a significantly higher 68Ga-FAPI-46 uptake than grade 2 tumors (SUVmax, 12.6 vs. 6.4; P = 0.009). Immunohistochemical FAP expression was high on tumor stroma ( 90
%K 18F-FDG PET/CT (Other)
%K 68Ga-FAPI-46 PET/CT (Other)
%K Molecular Imaging (Other)
%K Oncology: Liver (Other)
%K PET/CT (Other)
%K cholangiocarcinoma (Other)
%K conventional CT (Other)
%K immunohistochemistry (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:37024301
%R 10.2967/jnumed.122.265215
%U https://inrepo02.dkfz.de/record/275349