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. 2021 May;48(5):1593-1603.
doi: 10.1007/s00259-020-05070-9. Epub 2020 Oct 24.

Comparison of PET imaging of activated fibroblasts and 18F-FDG for diagnosis of primary hepatic tumours: a prospective pilot study

Ximin Shi  1 , Haiqun Xing  1 , Xiaobo Yang  2 , Fang Li  1 , Shaobo Yao  3 , Jia Congwei  4 , Haitao Zhao  2 , Marcus Hacker  5 , Li Huo  6 , Xiang Li  5
Affiliations

Comparison of PET imaging of activated fibroblasts and 18F-FDG for diagnosis of primary hepatic tumours: a prospective pilot study

Ximin Shi et al. Eur J Nucl Med Mol Imaging. 2021 May.

Abstract

Purpose: This study aimed to compare the performance of 68Ga-labelled fibroblast activating protein inhibitor (FAPI) PET and 18F-FDG PET for imaging of hepatic tumours.

Methods: We prospectively assessed 20 patients with suspected intrahepatic lesions. Tumour radiological features, pathology, or follow-up examinations were assessed as ground truth in correlation with PET scans. Semiquantitative analysis was additionally performed by measuring the standardised uptake value (SUV). Tumour-to-liver background ratios (TBR) were calculated and compared between 68Ga-FAPI PET and 18F-FDG PET. FAPI expression was assessed by immunochemistry in samples obtained from 7 patients with hepatocellular carcinomas (HCC)/intrahepatic cholangiocarcinoma (ICC) or granulomas.

Results: Primary intrahepatic tumours, including 16 HCC in 14 patients and 4 ICC in 3 patients with extrahepatic metastases, were determined by histology (n = 14) and clinical examinations (n = 3). Based on visual analysis, 17 patients presented elevated 68Ga-FAPI uptake (sensitivity: 100%, specificity: 100%), while 7 patients presented 18F-FDG avid tumours (sensitivity: 58.8%, specificity: 100%). 68Ga-FAPI PET/CT identified 17 extrahepatic metastases vs. 13 in 18F-FDG PET/CT in 2 ICC patients. Three benign liver nodules in three patients showed negligible uptake in dual-PET scans. The SUVmax_HCC = 8.47 ± 4.06 and TBRmax_HCC = 7.13 ± 5.52, and SUVmax_ICC = 14.14 ± 2.20 TBRmax_ICC = 26.46 ± 4.94 in 68Ga-FAPI-04 PET/CT were significantly higher than the 18F-FDG uptake presenting SUVmax_HCC = 4.86 ± 3.58 and TBRmax_HCC = 2.39 ± 2.21, and SUVmax_ICC = 9.19 ± 3.60 and TBRmax_ICC = 2.39 ± 2.21 (all p values < 0.05). ICC patients showed higher levels of FAPI uptake in the primary hepatic lesions compared to extrahepatic metastases, TBRmax_ICC = 15.18 ± 5.80 (p = 0.04).

Conclusions: 68Ga-FAPI PET-CT has superior potential in the detection of primary hepatic malignancy compared to 18F-FDG.

Keywords: 18F-FDG; 68Ga-FAPI-04; Fibroblast activating protein; Hepatic nodule; Hepatocellular carcinoma; Intrahepatic cholangiocarcinoma.

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References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. https://doi.org/10.3322/caac.21492 . - DOI
    1. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Journal of hepatology. 2012;56:908–43. https://doi.org/10.1016/j.jhep.2011.12.001 .
    1. Vogel A, Saborowski A. Cholangiocellular carcinoma. Digestion. 2017;95:181–5. https://doi.org/10.1159/000454763 . - DOI - PubMed
    1. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet (London, England). 2018;391:1301–14. https://doi.org/10.1016/s0140-6736(18)30010-2 . - DOI
    1. Amorim J, França M, Perez-Girbes A, Torregrosa A, Martí-Bonmatí L. Critical review of HCC imaging in the multidisciplinary setting: treatment allocation and evaluation of response. Abdominal radiology (New York). 2020;45:3119–28. https://doi.org/10.1007/s00261-020-02470-1 . - DOI

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