99mTc‑FAPI‑46 Scintigraphy for Staging of Non-Small Cell Lung Carcinoma.

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceuticals

Background:

• Accurate staging of squamous cell lung carcinoma is crucial for determining appropriate treatment strategies.
• Conventional imaging modalities like CT and bone scintigraphy may underestimate the true extent of metastatic disease.
• Novel imaging agents are needed to improve the detection of cancer spread.

Purpose of the Study:

• To evaluate the utility of 99mTc-FAPI-46 scintigraphy in staging a patient with squamous cell lung carcinoma.
• To compare the findings of 99mTc-FAPI-46 scintigraphy with conventional staging methods (CT and 99mTc-MDP bone scintigraphy).
• To assess the impact of 99mTc-FAPI-46 scintigraphy on stage migration and therapeutic intent.

Main Methods:

• A case report of a 71-year-old male patient with squamous cell lung carcinoma.
• Metastasis work-up using CT scan and 99mTc-MDP bone scintigraphy.
• Subsequent staging using 99mTc-FAPI-46 scintigraphy.

Main Results:

• Initial CT and bone scintigraphy suggested limited extrathoracic skeletal involvement.
• 99mTc-FAPI-46 scintigraphy identified a significantly greater disease burden, including extensive nodal and skeletal metastases.
• The findings led to a stage migration from presumed oligometastatic to polymetastatic Stage IV disease.

Conclusions:

• 99mTc-FAPI-46 scintigraphy demonstrated superior sensitivity in detecting metastatic disease compared to conventional methods in this case.
• This advanced imaging modality has the potential to significantly impact clinical decision-making and therapeutic intent.
• 99mTc-FAPI-46 scan represents a cost-effective staging option, especially where PET/CT is inaccessible or unaffordable.