Journal Article

DKFZ-2025-02626

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Potential value of [68Ga]Ga-FAPI-46 PET in patients with metastatic urothelial carcinoma: a bi-centric analysis.

Pabst, K. M.DKFZ* ; Siegmund, S. C. ; Holzgreve, A. ; Schmid, H. P. ; Bartel, T.DKFZ* ; Herrmann, K.DKFZ* ; Küper, A. T.DKFZ* ; Aydogdu, C. ; Kersting, D. ; Kesch, C. ; Hadaschik, B. A. ; Unterrainer, M. ; Stief, C. G. ; Cyran, C. C. ; Werner, R. A. ; Fendler, W. P.DKFZ* ; Casuscelli, J. ; Unterrainer, L. M.

2025
Springer-Verl. Heidelberg [u.a.]

Abstract: [68Ga]Ga-FAPI-46 has shown promise for urothelial cancer (UC) detection. This study evaluates its diagnostic value versus contrast-enhanced CT (ceCT) and 2-[18F]FDG PET in the largest bi-centric cohort to date.Patients with metastatic UC undergoing [68Ga]Ga-FAPI-46 PET at University Hospitals Munich or Essen were retrospectively reviewed. Detection rates were compared with ceCT on a regional basis (primary, lymph nodes, visceral organs, bone). SUVmax and SUVmean of two index lesions were recorded. In a sub-cohort, [68Ga]Ga-FAPI-46 and 2-[18F]FDG PET were compared on a lesion basis. Clinical follow-up and/or histopathology served as reference.Thirty-four patients underwent [68Ga]Ga-FAPI-46 PET/CT and ceCT, including 10 (29%) with additional 2-[18F]FDG PET/CT. Across 98 lesions (n = 65 regions), [68Ga]Ga-FAPI-46 PET detected n = 96 (98%) and ceCT n = 88 (90%), with mismatch findings in eight lymph nodes (PET positive/ceCT negative) and two visceral organs (ceCT positive/PET negative). In the subgroup comparison, 78 lesions were detected in total ([68Ga]Ga-FAPI-46: n = 72 (92%); 2-[18F]FDG: n = 78 (100%)). Tumour uptake was comparable (SUVmax [68Ga]Ga-FAPI-46 PET vs. 2-[18F]FDG: 10.2 (IQR, 1.9) vs. 8.0 (IQR, 3.3), p = 0.249), whereas [68Ga]Ga-FAPI-46 provided higher tumour-to-background ratios (Tumour-to-liver: 12.7 (IQR, 10.3) vs. 3.8 (IQR, 1.9), p = 0.046; tumour-to-spleen: 8.4 (IQR, 6.6) vs. 4.6 (IQR, 0.6), p = 0.016).[68Ga]Ga-FAPI-46 PET demonstrated higher regional detection rates than ceCT in UC patients, particularly for lymph node metastases. Compared to 2-[18F]FDG, it provided superior tumour-to-background contrast but detected slightly fewer lesions. [68Ga]Ga-FAPI-46 PET may complement established imaging in selected scenarios, although its role in routine UC staging remains investigational.

Keyword(s): 2-[18F]FDG-PET ; CeCT ; Detection efficacy ; Urothelial carcinoma ; [68Ga]Ga-FAPI-46 PET

Note: epub

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2025

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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