%0 Journal Article
%A Kessler, Lukas
%A Schwaning, Felix
%A Metzenmacher, Martin
%A Pabst, Kim M
%A Opitz, Marcel
%A Wiesweg, Marcel
%A Aigner, Clemens
%A Ploenes, Till
%A Boeloekbas, Servet
%A Doerr, Fabian
%A Stuschke, Martin
%A Umutlu, Lale
%A Nader, Michael
%A Theegarten, Dirk
%A Eberhardt, Wilfried E
%A Schuler, Martin
%A Herrmann, Ken
%A Fendler, Wolfgang P
%A Kersting, David
%A Hautzel, Hubertus
%T Prognostic Value of Fibroblast Activation Protein-Directed PET Imaging in Pleural Mesothelioma.
%J Journal of nuclear medicine
%V nn
%@ 0097-9058
%C New York, NY
%I Soc.
%M DKFZ-2026-00070
%P nn
%D 2026
%Z #DKTKZFB9# / #NCTZFB26# / epub
%X High expression of fibroblast activation protein (FAP) has been associated with inferior survival in several tumor entities. Novel 68Ga-radiolabeled FAP inhibitors (68Ga-FAPIs) allow noninvasive measurement of FAP, which enables the development of prognostic imaging parameters from 68Ga-FAPI PET/CT. In this study, we compared the prognostic value of 68Ga-FAPI-46 with 18F-FDG PET in a cohort of patients with malignant pleural mesothelioma from the FAPI PET observational trial (NCT04571086). Methods: Between May 2020 and January 2024, 49 patients with suspected or proven malignant mesothelioma were recruited, 39 of whom were eligible for data analysis. All patients underwent 68Ga-FAPI-46 and 18F-FDG PET/CT less than 4 wk apart. Tumor burden was measured semiautomatically, and SUVmax, SUVmean, and volumetric parameters (metabolic tumor volume [MTV], total lesion glycolysis/total lesion fibroblast activation, and total tumor SUV) were calculated. The FAP immunoreactive score (IRS) was calculated for tumor samples from a subset of patients (n = 19). Overall survival and progression-free survival were assessed per revised mRECIST (version 1.1). Survival analyses were performed with univariate and multivariate Cox regression and with Kaplan-Meier curves for clinical and imaging parameters, stratified by median. Results: Univariate analysis showed significant survival differences for all volumetric parameters for 68Ga-FAPI-46 and 18F-FDG (e.g., 68Ga-FAPI-46 MTV, 262 d vs. 737 d; P = 0.008 vs. 18F-FDG MTV, 336 d vs. 760 d; P = 0.012). Multivariate analysis revealed that MTV was an independent prognostic marker for 68Ga-FAPI-46 (hazard ratio, 4.44; 95
%K FAPI (Other)
%K cancer imaging (Other)
%K fibroblast activation protein (Other)
%K mesothelioma (Other)
%K theranostic (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:41506801
%R 10.2967/jnumed.125.270906
%U https://inrepo02.dkfz.de/record/307575