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@ARTICLE{Rhrich:289458,
      author       = {M. Röhrich and J. Daum and E. Gutjahr and A.-M. Spektor
                      and F. M. Glatting$^*$ and Y. A. Sahin and H. G. Buchholz
                      and J. Hoppner and C. Schroeter and E. Mavriopoulou and K.
                      Schlamp and M. Grott and F. Eichhorn and C. P. Heußel and
                      H. U. Kauczor and M. Kreuter and F. Giesel$^*$ and M.
                      Schreckenberger and H. Winter and U. Haberkorn$^*$},
      title        = {{D}iagnostic {P}otential of {S}upplemental {S}tatic and
                      {D}ynamic 68{G}a-{FAPI}-46 {PET} for {P}rimary
                      18{F}-{FDG}-{N}egative {P}ulmonary {L}esions.},
      journal      = {Journal of nuclear medicine},
      volume       = {65},
      number       = {6},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2024-00780},
      pages        = {872-879},
      year         = {2024},
      note         = {#LA:E060# / 2024 Jun 3;65(6):872-879},
      abstract     = {PET 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.},
      keywords     = {FAPI (Other) / PET (Other) / fibroblast activation protein
                      (Other) / lung cancer (Other) / pulmonary lesions (Other)},
      cin          = {E055 / HD01 / E060},
      ddc          = {610},
      cid          = {I:(DE-He78)E055-20160331 / I:(DE-He78)HD01-20160331 /
                      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:38604763},
      doi          = {10.2967/jnumed.123.267103},
      url          = {https://inrepo02.dkfz.de/record/289458},
}