학술논문
[68 Ga]Ga-FAPI-46 PET/CT for locoregional lymph node staging in urothelial carcinoma of the bladder prior to cystectomy: initial experiences from a pilot analysis
Document Type
Brief Communication
Author
Unterrainer, Lena M.; Eismann, Lennert; Lindner, Simon; Gildehaus, Franz-Josef; Toms, Johannes; Casuscelli, Jozefina; Holzgreve, Adrien; Kunte, Sophie C.; Cyran, Clemens C.; Menold, Paula; Karl, Alexander; Unterrainer, Marcus; Ledderose, Stephan T.; Stief, Christian G.; Bartenstein, Peter; Kretschmer, Alexander; Schulz, Gerald B.
Source
European Journal of Nuclear Medicine and Molecular Imaging. 51(6):1786-1789
Subject
Language
English
ISSN
1619-7070
1619-7089
1619-7089
Abstract
Introduction: [68 Ga]Ga-FAPI-46 PET/CT is a novel hybrid imaging method that previously showed additional diagnostic value in the assessment of distant urothelial carcinoma lesions. We hypothesized that patients with bladder cancer benefit from [68 Ga]Ga-FAPI-46 PET/CT prior to radical cystectomy for locoregional lymph node staging.Materials and methods: Eighteen patients underwent [68 Ga]Ga-FAPI-46 PET/CT for evaluation of lymph node (LN) status in predefined LN regions. Two hundred twenty-nine intraoperatively removed LN served as histopathological reference standard.Results: Urothelial carcinoma (UC) spread was found in ten LN in seven different regions (14.3%). Hereby, [68 Ga]Ga-FAPI-46 PET/CT was positive in four out of seven regions (57.1%) and showed significantly increased FAPI uptake compared to non-pathological regions. In the remaining three out of seven (42.9%) regions, [68 Ga]Ga-FAPI-46 PET/CT was rated negative since no pathological increased FAPI uptake was detected or the proximity of the urinary tract prevented a differentiation from physiological uptake. CT was inconspicuous in these three regions. In total, two FAP-positive LN regions were found without histopathological counterpart. Overall, sensitivity, specificity, positive predictive value, and negative predictive value were 57.1%, 95.2%, 66.7%, and 93.0% for PET imaging.Conclusion: In summary, this innovative [68 Ga]Ga-FAPI-46 PET/CT method showed high specificity and negative predictive value in patients with bladder UC with a future potential to optimize therapy planning.