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Prospective Study Comparing [99mTc]Tc-DP-FAPI Quantitative SPECT/CT with [68Ga]Ga-FAPI-04 PET/CT in Patients with

Cheng Zhou1, Guoquan Li1, Zhiyong Quan1

  • 1Department of Nuclear Medicine and State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710000, China.

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This summary is machine-generated.

Technetium-99m-labeled fibroblast activation protein inhibitors ([99mTc]Tc-DP-FAPI) show high sensitivity for primary gastrointestinal tumors. While effective for initial screening, [99mTc]Tc-DP-FAPI has limitations in detecting metastases compared to Gallium-68-labeled ([68Ga]Ga-FAPI-04) imaging.

Keywords:
Tc-99mfibroblast activation protein inhibitors (FAPI)gastrointestinal tumorsprospective studyquantitative SPECT/CT

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Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiochemistry

Background:

  • [68Ga]Ga-FAPI-04 PET/CT is established for tumor imaging.
  • 99mTc-labeled fibroblast activation protein inhibitors (FAPI) have shown safe biodistribution.
  • Limited studies exist on 99mTc-labeled FAPI for tumor imaging.

Purpose of the Study:

  • To evaluate the accuracy of [99mTc]Tc-DP-FAPI in diagnosing gastrointestinal tumors.
  • To compare the diagnostic performance of [99mTc]Tc-DP-FAPI with [68Ga]Ga-FAPI-04.
  • To assess the utility of [99mTc]Tc-DP-FAPI for lesion detection and staging.

Main Methods:

  • Prospective study of 24 patients with diagnosed gastrointestinal tumors.
  • Quantitative SPECT/CT imaging with [99mTc]Tc-DP-FAPI.
  • PET/CT imaging with [68Ga]Ga-FAPI-04 on consecutive days.
  • Comparative analysis of lesion detection sensitivity and specificity.

Main Results:

  • Both [99mTc]Tc-DP-FAPI and [68Ga]Ga-FAPI-04 demonstrated 100% sensitivity for primary gastrointestinal tumors.
  • [99mTc]Tc-DP-FAPI showed low sensitivity (32.8%) and specificity (10.9%) for lymph node metastasis detection.
  • [68Ga]Ga-FAPI-04 detected significantly more lymph nodes (57) and distant metastases (9) compared to [99mTc]Tc-DP-FAPI (3 metastases).
  • [68Ga]Ga-FAPI-04 exhibited higher sensitivity (89.1%) and specificity (67.2%) for lymph node detection.

Conclusions:

  • [99mTc]Tc-DP-FAPI is highly sensitive for detecting primary gastrointestinal tumors.
  • While [99mTc]Tc-DP-FAPI matches [68Ga]Ga-FAPI-04 for primary tumor detection, it is limited in identifying metastases.
  • [99mTc]Tc-DP-FAPI holds value for preliminary screening and early diagnosis of suspected gastrointestinal tumors.