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@ARTICLE{Pabst:306585,
author = {K. M. Pabst$^*$ and S. C. Siegmund and A. Holzgreve and H.
P. Schmid and T. Bartel$^*$ and K. Herrmann$^*$ and A. T.
Küper$^*$ and C. Aydogdu and D. Kersting and C. Kesch and
B. A. Hadaschik and M. Unterrainer and C. G. Stief and C. C.
Cyran and R. A. Werner and W. P. Fendler$^*$ and J.
Casuscelli and L. M. Unterrainer},
title = {{P}otential value of [68{G}a]{G}a-{FAPI}-46 {PET} in
patients with metastatic urothelial carcinoma: a bi-centric
analysis.},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {nn},
issn = {1619-7070},
address = {Heidelberg [u.a.]},
publisher = {Springer-Verl.},
reportid = {DKFZ-2025-02626},
pages = {nn},
year = {2025},
note = {epub},
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.},
keywords = {2-[18F]FDG-PET (Other) / CeCT (Other) / Detection efficacy
(Other) / Urothelial carcinoma (Other) / [68Ga]Ga-FAPI-46
PET (Other)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41288692},
doi = {10.1007/s00259-025-07674-5},
url = {https://inrepo02.dkfz.de/record/306585},
}