Universität zu Köln

Wegen, Simone ORCID: 0000-0002-0361-728X, Claus, Karina, Linde, Philipp ORCID: 0000-0002-2813-1331, Rosenbrock, Johannes ORCID: 0000-0003-3340-0556, Trommer, Maike ORCID: 0000-0003-2864-4273, Zander, Thomas ORCID: 0000-0002-4266-6818, Tuchscherer, Armin ORCID: 0000-0001-9534-4639, Bruns, Christiane ORCID: 0000-0001-6590-8181, Schlößer, Hans Anton ORCID: 0000-0002-1304-7719, Schröder, Wolfgang ORCID: 0000-0002-8700-069X, Eich, Marie-Lisa ORCID: 0000-0002-8601-4598, Fischer, Thomas ORCID: 0000-0001-6118-5182, Schomäcker, Klaus ORCID: 0000-0003-2636-0058, Drzezga, Alexander ORCID: 0000-0001-6018-716X, Kobe, Carsten ORCID: 0000-0002-2909-0826, Roth, Katrin Sabine ORCID: 0009-0001-6766-9273 and Weindler, Jasmin Josefine ORCID: 0009-0001-8810-0617 (2024). Impact of FAPI-46/dual-tracer PET/CT imaging on radiotherapeutic management in esophageal cancer. Radiation Oncology, 19 (1). pp. 1-11. Springer Nature. ISSN 1748-717X

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Abstract

[Artikel-Nr.: 44] Background: Fibroblast activation protein (FAP) is expressed in the tumor microenvironment (TME) of various cancers. In our analysis, we describe the impact of dual-tracer imaging with Gallium-68-radiolabeled inhibitors of FAP (FAPI-46-PET/CT) and fluorodeoxy-D-glucose (FDG-PET/CT) on the radiotherapeutic management of primary esophageal cancer (EC). Methods: 32 patients with EC, who are scheduled for chemoradiation, received FDG and FAPI-46 PET/CT on the same day (dual-tracer protocol, 71%) or on two separate days (29%) We compared functional tumor volumes (FTVs), gross tumor volumes (GTVs) and tumor stages before and after PET-imaging. Changes in treatment were categorized as “minor” (adaption of radiation field) or “major” (change of treatment regimen). Immunohistochemistry (IHC) staining for FAP was performed in all patients with available tissue. Results: Primary tumor was detected in all FAPI-46/dual-tracer scans and in 30/32 (93%) of FDG scans. Compared to the initial staging CT scan, 12/32 patients (38%) were upstaged in nodal status after the combination of FDG and FAPI-46 PET scans. Two lymph node metastases were only visible in FAPI-46/dual-tracer. New distant metastasis was observed in 2/32 (6%) patients following FAPI-4 -PET/CT. Our findings led to larger RT fields (“minor change”) in 5/32 patients (16%) and changed treatment regimen (“major change”) in 3/32 patients after FAPI-46/dual-tracer PET/CT. GTVs were larger in FAPI-46/dual-tracer scans compared to FDG-PET/CT (mean 99.0 vs. 80.3 ml, respectively ( p < 0.001)) with similar results for nuclear medical FTVs. IHC revealed heterogenous FAP-expression in all specimens (mean H-score: 36.3 (SD 24.6)) without correlation between FAP expression in IHC and FAPI tracer uptake in PET/CT. Conclusion: We report first data on the use of PET with FAPI-46 for patients with EC, who are scheduled to receive RT. Tumor uptake was high and not depending on FAP expression in TME. Further, FAPI-46/dual-tracer PET had relevant impact on management in this setting. Our data calls for prospective evaluation of FAPI-46/dual-tracer PET to improve clinical outcomes of EC.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Wegen, Simone UNSPECIFIED https://orcid.org/0000-0002-0361-728X UNSPECIFIED Claus, Karina UNSPECIFIED UNSPECIFIED UNSPECIFIED Linde, Philipp UNSPECIFIED https://orcid.org/0000-0002-2813-1331 UNSPECIFIED Rosenbrock, Johannes UNSPECIFIED https://orcid.org/0000-0003-3340-0556 UNSPECIFIED Trommer, Maike UNSPECIFIED https://orcid.org/0000-0003-2864-4273 UNSPECIFIED Zander, Thomas UNSPECIFIED https://orcid.org/0000-0002-4266-6818 UNSPECIFIED Tuchscherer, Armin UNSPECIFIED https://orcid.org/0000-0001-9534-4639 UNSPECIFIED Bruns, Christiane UNSPECIFIED https://orcid.org/0000-0001-6590-8181 UNSPECIFIED Schlößer, Hans Anton UNSPECIFIED https://orcid.org/0000-0002-1304-7719 UNSPECIFIED Schröder, Wolfgang UNSPECIFIED https://orcid.org/0000-0002-8700-069X UNSPECIFIED Eich, Marie-Lisa UNSPECIFIED https://orcid.org/0000-0002-8601-4598 UNSPECIFIED Fischer, Thomas UNSPECIFIED https://orcid.org/0000-0001-6118-5182 UNSPECIFIED Schomäcker, Klaus UNSPECIFIED https://orcid.org/0000-0003-2636-0058 UNSPECIFIED Drzezga, Alexander UNSPECIFIED https://orcid.org/0000-0001-6018-716X UNSPECIFIED Kobe, Carsten UNSPECIFIED https://orcid.org/0000-0002-2909-0826 UNSPECIFIED Roth, Katrin Sabine UNSPECIFIED https://orcid.org/0009-0001-6766-9273 UNSPECIFIED Weindler, Jasmin Josefine UNSPECIFIED https://orcid.org/0009-0001-8810-0617 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-815314
Identification Number:	10.1186/s13014-024-02430-9
Journal or Publication Title:	Radiation Oncology
Volume:	19
Number:	1
Page Range:	pp. 1-11
Number of Pages:	11
Date:	4 April 2024
Publisher:	Springer Nature
ISSN:	1748-717X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik I für Innere Medizin - Hämatologie und Onkologie Faculty of Medicine > Nuklearmedizin > Klinik und Poliklinik für Nuklearmedizin Faculty of Medicine > Strahlentherapie > Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie Zentrum für Molekulare Medizin
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language FDG ; Esophageal cancer ; FAPI-46 ; Radiotherapy planning ; PET-based English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81531