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Automated Preparation of [68Ga]Ga-3BP-3940 on a Synthesis Module for PET Imaging of the Tumor Microenvironment
Published on: April 25, 2025
The FAP-FDG Integration Score (FFIS): Development and prognostic validation of a dual-tracer PET phenotype for solid
Ya Liu1,2,3, Ting Zhang4, Jingwei Deng1,2,3
1Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China.
Summary
A novel FAP-FDG integrated score (FFIS) using PET/CT imaging shows significant prognostic value for solid tumors. This integrated score effectively stratifies patient risk and predicts overall survival better than single-tracer imaging.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiomics
Background:
- Accurate prognostic assessment is crucial for optimizing cancer patient management.
- Current imaging biomarkers like [18F]F-FDG PET/CT offer valuable insights but may not capture the full tumor heterogeneity.
- Fibroblast Activation Protein (FAP) targeted imaging, such as with [68Ga]Ga-FAP-2286, provides complementary information about the tumor microenvironment.
Purpose of the Study:
- To develop a FAP-FDG integrated score (FFIS) by combining [68Ga]Ga-FAP-2286 and [18F]F-FDG PET/CT data.
- To evaluate the prognostic value of the FFIS for risk stratification in patients with solid tumors.
- To compare the prognostic performance of FFIS against conventional single-parameter imaging metrics (FDG-SUVmax and FAP-SUVmax).
Main Methods:
- Retrospective analysis of 193 solid tumor patients who underwent both [18F]F-FDG and [68Ga]Ga-FAP-2286 PET/CT scans.
- Development of the FFIS based on the uptake intensity and patterns of both radiotracers.
- Prognostic evaluation using Kaplan-Meier survival analysis, univariate and multivariate Cox proportional hazards models, and subgroup analyses.
Main Results:
- The FFIS was identified as an independent predictor of overall survival (OS) in both univariate and multivariate analyses (HR=1.79 and 1.75, respectively; P<0.001).
- Higher FFIS scores correlated with significantly worse survival outcomes, with median OS decreasing from score 1 (no deaths) to score 4 (8 months).
- In contrast, [18F]F-FDG SUVmax showed no independent prognostic value, and [68Ga]Ga-FAP-2286 SUVmax was only predictive in univariate analysis.
Conclusions:
- The integrated FFIS, combining metabolic and stromal information from PET/CT, demonstrates significant prognostic value in solid tumors.
- FFIS offers superior risk stratification compared to individual radiotracer uptake metrics.
- This integrated imaging approach may enhance prognostic assessment and guide clinical decision-making for cancer patients.
