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000289458 1001_ $$aRöhrich, Manuel$$b0
000289458 245__ $$aDiagnostic Potential of Supplemental Static and Dynamic 68Ga-FAPI-46 PET for Primary 18F-FDG-Negative Pulmonary Lesions.
000289458 260__ $$aNew York, NY$$bSoc.$$c2024
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000289458 500__ $$a#LA:E060# / 2024 Jun 3;65(6):872-879
000289458 520__ $$aPET using 68Ga-labeled fibroblast activation protein (FAP) inhibitors (FAPIs) holds high potential for diagnostic imaging of various malignancies, including lung cancer (LC). However, 18F-FDG PET is still the clinical gold standard for LC imaging. Several subtypes of LC, especially lepidic LC, are frequently 18F-FDG PET-negative, which markedly hampers the assessment of single pulmonary lesions suggestive of LC. Here, we evaluated the diagnostic potential of static and dynamic 68Ga-FAPI-46 PET in the 18F-FDG-negative pulmonary lesions of 19 patients who underwent surgery or biopsy for histologic diagnosis after PET imaging. For target validation, FAP expression in lepidic LC was confirmed by FAP immunohistochemistry. Methods: Hematoxylin and eosin staining and FAP immunohistochemistry of 24 tissue sections of lepidic LC from the local tissue bank were performed and analyzed visually. Clinically, 19 patients underwent static and dynamic 68Ga-FAPI-46 PET in addition to 18F-FDG PET based on individual clinical indications. Static PET data of both examinations were analyzed by determining SUVmax, SUVmean, and tumor-to-background ratio (TBR) against the blood pool, as well as relative parameters (68Ga-FAPI-46 in relation to18F-FDG), of histologically confirmed LC and benign lesions. Time-activity curves and dynamic parameters (time to peak, slope, k 1, k 2, k 3, and k 4) were extracted from dynamic 68Ga-FAPI-46 PET data. The sensitivity and specificity of all parameters were analyzed by calculating receiver-operating-characteristic curves. Results: FAP immunohistochemistry confirmed the presence of strongly FAP-positive cancer-associated fibroblasts in lepidic LC. LC showed markedly elevated 68Ga-FAPI-46 uptake, higher TBRs, and higher 68Ga-FAPI-46-to-18F-FDG ratios for all parameters than did benign pulmonary lesions. Dynamic imaging analysis revealed differential time-activity curves for LC and benign pulmonary lesions: initially increasing time-activity curves with a decent slope were typical of LC, and steadily decreasing time-activity curve indicated benign pulmonary lesions, as was reflected by a significantly increased time to peak and significantly smaller absolute values of the slope for LC. Relative 68Ga-FAPI-46-to-18F-FDG ratios regarding SUVmax and TBR showed the highest sensitivity and specificity for the discrimination of LC from benign pulmonary lesions. Conclusion: 68Ga-FAPI-46 PET is a powerful new tool for the assessment of single 18F-FDG-negative pulmonary lesions and may optimize patient stratification in this clinical setting.
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000289458 650_7 $$2Other$$aFAPI
000289458 650_7 $$2Other$$aPET
000289458 650_7 $$2Other$$afibroblast activation protein
000289458 650_7 $$2Other$$alung cancer
000289458 650_7 $$2Other$$apulmonary lesions
000289458 7001_ $$aDaum, Johanna$$b1
000289458 7001_ $$aGutjahr, Ewgenija$$b2
000289458 7001_ $$aSpektor, Anna-Maria$$b3
000289458 7001_ $$0P:(DE-He78)1fc3c2327d9c213c36fe740ef63e1baa$$aGlatting, Frederik M$$b4$$udkfz
000289458 7001_ $$aSahin, Yasemin Aylin$$b5
000289458 7001_ $$aBuchholz, Hans Georg$$b6
000289458 7001_ $$aHoppner, Jorge$$b7
000289458 7001_ $$aSchroeter, Cathrin$$b8
000289458 7001_ $$aMavriopoulou, Eleni$$b9
000289458 7001_ $$aSchlamp, Kai$$b10
000289458 7001_ $$aGrott, Matthias$$b11
000289458 7001_ $$aEichhorn, Florian$$b12
000289458 7001_ $$aHeußel, Claus Peter$$b13
000289458 7001_ $$aKauczor, Hans Ulrich$$b14
000289458 7001_ $$aKreuter, Michael$$b15
000289458 7001_ $$0P:(DE-He78)5ca7e97b2769bb97f8c73431c6566b94$$aGiesel, Frederik$$b16
000289458 7001_ $$aSchreckenberger, Mathias$$b17
000289458 7001_ $$aWinter, Hauke$$b18
000289458 7001_ $$0P:(DE-He78)13a0afba029f5f64dc18b25ef7499558$$aHaberkorn, Uwe$$b19$$eLast author$$udkfz
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