Universität zu Köln

Wegen, Simone ORCID: 0000-0002-0361-728X, van Heek, Lutz, Linde, Philipp, Claus, Karina, Akuamoa-Boateng, Dennis, Baues, Christian, Sharma, Shachi Jenny, Schomaecker, Klaus, Fischer, Thomas, Roth, Katrin Sabine, Klussmann, Jens Peter, Marnitz, Simone, Drzezga, Alexander and Kobe, Carsten (2022). Head-to-Head Comparison of [Ga-68]Ga-FAPI-46-PET/CT and [F-18]F-FDG-PET/CT for Radiotherapy Planning in Head and Neck Cancer. Mol. Imaging. Biol., 24 (6). S. 986 - 995. NEW YORK: SPRINGER. ISSN 1860-2002

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Abstract

Introduction In head and neck cancers (HNCs), fibroblast activation protein (FAP) is expressed by cancer-associated fibroblasts (CAFs) in the tumor microenvironment. Preliminary evidence suggests that detection and staging is feasible with positron emission tomography (PET/CT) imaging using [(68) Ga]-radiolabeled inhibitors of FAP ([(68) Ga]Ga-FAPI-46) in HNCs. This study aims to compare [(68) Ga]Ga-FAPI-46 PET/CT and [F-18]-fluorodeoxy-d-glucose ([F-18]F-FDG) PET/CT with a focus on improved target volume definition and radiotherapy planning in patients with HNC referred for chemoradiation. Methods A total of 15 patients with HNCs received both [(68) Ga]Ga-FAPI-46 PET/CT and [F-18]F-FDG PET/CT with a thermoplastic mask, in addition to initial tumor staging by conventional imaging with contrast-enhanced CT and/or MRI. Mean intervals between FAPI/FDG and FAPI/conventional imaging were 4 +/- 20 and 17 +/- 18 days, respectively. Location and number of suspicious lesions revealed by the different procedures were recorded. Subsequently, expert-generated gross tumor volumes (GTVs) based on conventional imaging were compared to those based on [F-18]F-FDG and [(68) Ga]Ga-FAPI-46 PET/CT to measure the impact on subsequent radiation planning. Results All patients had focal FAPI uptake above background in tumor lesions. Compared to FDG, tumor uptake (median SUVmax 10.2 vs. 7.3, p = 0.008) and tumor-to-background ratios were significantly higher with FAPI than with FDG (SUVmean liver: 9.3 vs. 3.2, p < 0.001; SUVmean bloodpool: 6.9 vs. 4.0, p < 0.001). A total of 49 lesions were recorded. Of these, 40 (82%) were FDG(+) and 41 (84%) were FAP(+). There were 5 (10%) FAP(+)/FDG(-) lesions and 4 (8%) FAP(-)/FDG(+) lesions. Volumetrically, a significant difference was found between the GTVs (median 57.9 ml in the FAPI-GTV, 42.5 ml in the FDG-GTV, compared to 39.2 ml in the conventional-GTV). Disease stage identified by FAPI PET/CT was mostly concordant with FDG PET/CT. Compared to conventional imaging, five patients (33%) were upstaged following imaging with FAPI and FDG PET/CT. Conclusion We demonstrate that [(68) Ga]Ga-FAPI-46 -PET/CT is useful for detecting tumor lesions in patients with HNCs. There is now a need for prospective randomized studies to confirm the role of [(68) Ga]Ga-FAPI-46 PET/CT in relation to [F-18]F-FDG PET/CT in HNCs and to evaluate its impact on clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wegen, Simone UNSPECIFIED orcid.org/0000-0002-0361-728X UNSPECIFIED van Heek, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED Linde, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Claus, Karina UNSPECIFIED UNSPECIFIED UNSPECIFIED Akuamoa-Boateng, Dennis UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Sharma, Shachi Jenny UNSPECIFIED UNSPECIFIED UNSPECIFIED Schomaecker, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Katrin Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Klussmann, Jens Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-676693
DOI:	10.1007/s11307-022-01749-7
Journal or Publication Title:	Mol. Imaging. Biol.
Volume:	24
Number:	6
Page Range:	S. 986 - 995
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1860-2002
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; PET Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67669