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Updated: Aug 12, 2025
![An Automated Radiosynthesis of [68Ga]Ga-FAPI-46 for Routine Clinical Use](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F66708.jpg&w=3840&q=50)
An Automated Radiosynthesis of [68Ga]Ga-FAPI-46 for Routine Clinical Use
Published on: May 24, 2024
68 Ga-DOTA.SA.FAPI as a Potential, Noninvasive Diagnostic Probe for Recurrent and Metastatic Adrenocortical Carcinoma
Sejal Chopra1, Rama Walia2, Yamini Mathur1
1From the Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
Metastatic or recurrent adrenocortical carcinoma (ACC) is a potentially fatal malignancy, which poses major challenges in disease management owing to lack of effective systemic therapies. The drastically reduced survival rates require prompt identification of selective molecules for development of targeted therapeutics. We evaluated the squaric acid containing FAPI derivative, DOTA.SA.FAPI (FAPI), as a potential diagnostic probe in 2 cases of histopathologically proven metastatic and recurrent ACC. Both patients underwent 18 F-FDG and 68 Ga-FAPI PET/CT scans for comparative analysis. 68 Ga-DOTA.SA.FAPI emerged as an excellent diagnostic agent for ACC and performed similar to 18 F-FDG.
Insights
Squaric acid-based FAPI derivative (FAPI) shows promise as a diagnostic tool for metastatic adrenocortical carcinoma (ACC). This novel agent performed comparably to 18F-FDG PET/CT in initial patient evaluations.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiochemistry
Background:
- Adrenocortical carcinoma (ACC) is a rare but aggressive endocrine malignancy with poor prognosis, especially in metastatic or recurrent stages.
- Effective systemic therapies are limited, highlighting the need for improved diagnostic and therapeutic strategies.
- Targeted molecular imaging agents are crucial for precise disease detection and management.
Purpose of the Study:
- To evaluate the diagnostic utility of a novel squaric acid-containing fibroblast activation protein inhibitor (FAPI) derivative, DOTA.SA.FAPI (FAPI), in patients with metastatic or recurrent ACC.
- To compare the performance of 68Ga-FAPI PET/CT with the standard 18F-FDG PET/CT in diagnosing ACC.
Main Methods:
- Two patients with histopathologically confirmed metastatic/recurrent ACC underwent both 18F-FDG PET/CT and 68Ga-FAPI PET/CT scans.
- Comparative analysis of imaging findings from both modalities was performed.
Main Results:
- 68Ga-FAPI PET/CT demonstrated excellent diagnostic capability for metastatic and recurrent ACC.
- The diagnostic performance of 68Ga-FAPI PET/CT was found to be similar to that of 18F-FDG PET/CT.
Conclusions:
- DOTA.SA.FAPI (FAPI) shows significant potential as a diagnostic imaging agent for adrenocortical carcinoma.
- 68Ga-FAPI PET/CT represents a promising alternative or complementary imaging modality to 18F-FDG PET/CT for ACC management.
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