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Initial Evaluation of [

Tadashi Watabe1,2, Sadahiro Naka3, Mitsuaki Tatsumi4

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The novel 18F-labeled fibroblast activation protein inhibitor ([18F]FAPI-74) PET imaging shows higher uptake and detection rates for various cancers compared to [18F]FDG PET, aiding in precise tumor staging.

Keywords:
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Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiochemistry

Background:

  • Fibroblast activation protein (FAP) is upregulated in many cancer-associated fibroblasts.
  • [18F]FAPI-74 offers advantages in synthetic yield and image resolution over 68Ga-labeled FAPI.
  • Accurate tumor imaging is crucial for diagnosis, staging, and treatment planning.

Purpose of the Study:

  • To evaluate the preliminary diagnostic performance of [18F]FAPI-74 PET in patients with various cancers.
  • To compare the uptake and detection capabilities of [18F]FAPI-74 PET with [18F]FDG PET.
  • To assess the potential of [18F]FAPI-74 PET as a diagnostic tool for tumor characterization.

Main Methods:

  • 31 patients with histopathologically confirmed cancers or suspected malignancies underwent [18F]FAPI-74 PET scans.
  • Images were analyzed for tracer uptake (SUVmax) in primary, recurrent, and metastatic lesions.
  • Comparison of [18F]FAPI-74 PET findings with [18F]FDG PET in 19 patients.

Main Results:

  • [18F]FAPI-74 PET showed higher uptake in malignant lesions compared to nonmalignant lesions (P=0.053).
  • [18F]FAPI-74 PET demonstrated significantly higher uptake than [18F]FDG PET in primary lesions, lymph node metastases, and other metastases (P≤0.046).
  • [18F]FAPI-74 PET detected more metastatic lesions than [18F]FDG PET in 6 patients.

Conclusions:

  • [18F]FAPI-74 PET exhibits superior uptake and detection rates for primary and metastatic tumors compared to [18F]FDG PET.
  • This tracer is a promising tool for precise tumor staging and characterization, especially in the preoperative setting.
  • [18F]FAPI-74 PET may fulfill a significant clinical demand for advanced cancer diagnostics in the future.