Head-to-Head Comparison of the Accuracy of Ga-68-FAPI and F-18-FDG PET in the Diagnosis of Tumors

Ziel/Aim To assess the accuracy of Ga-68-FAPI and F-18-FDG PET in the diagnosis of tumors, we performed a head-to-head comparison of both imaging modalities across a range of tumor entities.

Methodik/Methods One hundred and forty-six patients with eleven tumor entities who received concomitant imaging with Ga-68-FAPI PET and F-18-FDG PET for tumor staging or restaging between October 2018 and March 2022 were included. Each scan was evaluated for the detection of primary tumor, lymph nodes, visceral and bone metastases. True or false positivity and negativity to detected lesions were assigned based on histopathology from biopsies or surgical excision, as well as imaging validation (confirmed by presence on initial and follow-up scans, and change in size, disappearance, or appearance on follow-up imaging during treatment).

Ergebnisse/Results Ga-68-FAPI PET shows a better accuracy than F-18-FDG PET in the detection of prostate cancer (N=22, per-patient: 100 vs. 90.9%, respectively; per-region: 96.4 vs. 92.7%, respectively) and colorectal cancer (N=14, per-patient: 85.7 vs. 78.6%, respectively; per-region: 95.6 vs. 91.1%, respectively). Ga-68-FAPI PET and F-18-FDG PET have comparable per-patient accuracy in detecting cancers of the head and neck (N=10, 90% for both modalities), breast (N=16, 100%), lung (N=9, 88.9%), pleura (N=21, 100%), and cholangiocellular carcinoma (N=13, 100%). Ga-68-FAPI PET underperforms in per-patient accuracy compared to F-18-FDG PET with cancers of the kidney (N=10, per-patient: 80 vs. 90%), bladder (N=12, per-patient: 75 vs. 100%), myeloma (N=10, per-patient: 80 vs. 90%) and lymphoma (N=9, per-patient: 88.9 vs. 100%).

Schlussfolgerungen/Conclusions Ga-68-FAPI PET demonstrated higher accuracy for prostate and colorectal cancers, and comparable diagnostic performance for head and neck, breast, lung, pleura, and cholangiocellular carcinoma when compared with F-18-FDG. Accuracy and impact on management will further be assessed in an ongoing prospective interventional trial (NCT05160051).

Publikationsverlauf

Artikel online veröffentlicht:
30. März 2023