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000306585 1001_ $$00000-0002-9234-0795$$aPabst, Kim M$$b0
000306585 245__ $$aPotential value of [68Ga]Ga-FAPI-46 PET in patients with metastatic urothelial carcinoma: a bi-centric analysis.
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000306585 520__ $$a[68Ga]Ga-FAPI-46 has shown promise for urothelial cancer (UC) detection. This study evaluates its diagnostic value versus contrast-enhanced CT (ceCT) and 2-[18F]FDG PET in the largest bi-centric cohort to date.Patients with metastatic UC undergoing [68Ga]Ga-FAPI-46 PET at University Hospitals Munich or Essen were retrospectively reviewed. Detection rates were compared with ceCT on a regional basis (primary, lymph nodes, visceral organs, bone). SUVmax and SUVmean of two index lesions were recorded. In a sub-cohort, [68Ga]Ga-FAPI-46 and 2-[18F]FDG PET were compared on a lesion basis. Clinical follow-up and/or histopathology served as reference.Thirty-four patients underwent [68Ga]Ga-FAPI-46 PET/CT and ceCT, including 10 (29%) with additional 2-[18F]FDG PET/CT. Across 98 lesions (n = 65 regions), [68Ga]Ga-FAPI-46 PET detected n = 96 (98%) and ceCT n = 88 (90%), with mismatch findings in eight lymph nodes (PET positive/ceCT negative) and two visceral organs (ceCT positive/PET negative). In the subgroup comparison, 78 lesions were detected in total ([68Ga]Ga-FAPI-46: n = 72 (92%); 2-[18F]FDG: n = 78 (100%)). Tumour uptake was comparable (SUVmax [68Ga]Ga-FAPI-46 PET vs. 2-[18F]FDG: 10.2 (IQR, 1.9) vs. 8.0 (IQR, 3.3), p = 0.249), whereas [68Ga]Ga-FAPI-46 provided higher tumour-to-background ratios (Tumour-to-liver: 12.7 (IQR, 10.3) vs. 3.8 (IQR, 1.9), p = 0.046; tumour-to-spleen: 8.4 (IQR, 6.6) vs. 4.6 (IQR, 0.6), p = 0.016).[68Ga]Ga-FAPI-46 PET demonstrated higher regional detection rates than ceCT in UC patients, particularly for lymph node metastases. Compared to 2-[18F]FDG, it provided superior tumour-to-background contrast but detected slightly fewer lesions. [68Ga]Ga-FAPI-46 PET may complement established imaging in selected scenarios, although its role in routine UC staging remains investigational.
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000306585 650_7 $$2Other$$a2-[18F]FDG-PET
000306585 650_7 $$2Other$$aCeCT
000306585 650_7 $$2Other$$aDetection efficacy
000306585 650_7 $$2Other$$aUrothelial carcinoma
000306585 650_7 $$2Other$$a[68Ga]Ga-FAPI-46 PET
000306585 7001_ $$aSiegmund, Sophie C$$b1
000306585 7001_ $$aHolzgreve, Adrien$$b2
000306585 7001_ $$aSchmid, Hans P$$b3
000306585 7001_ $$0P:(DE-HGF)0$$aBartel, Timo$$b4
000306585 7001_ $$0P:(DE-HGF)0$$aHerrmann, Ken$$b5
000306585 7001_ $$0P:(DE-HGF)0$$aKüper, Alina T$$b6
000306585 7001_ $$aAydogdu, Can$$b7
000306585 7001_ $$aKersting, David$$b8
000306585 7001_ $$aKesch, Claudia$$b9
000306585 7001_ $$aHadaschik, Boris A$$b10
000306585 7001_ $$aUnterrainer, Marcus$$b11
000306585 7001_ $$aStief, Christian G$$b12
000306585 7001_ $$aCyran, Clemens C$$b13
000306585 7001_ $$aWerner, Rudolf A$$b14
000306585 7001_ $$0P:(DE-HGF)0$$aFendler, Wolfgang P$$b15
000306585 7001_ $$aCasuscelli, Jozefina$$b16
000306585 7001_ $$aUnterrainer, Lena M$$b17
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