[68 Ga]Ga-FAPI-46 PET/CT for locoregional lymph node staging in urothelial carcinoma of the bladder prior to cystectomy

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 und Schulz, Gerald B. (2024): [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. In: European Journal of Nuclear Medicine and Molecular Imaging, Bd. 51, Nr. 6: S. 1786-1789

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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Pathologisches Institut ; Medizin > Klinikum der LMU München > Klinik und Poliklinik für Nuklearmedizin ; Medizin > Klinikum der LMU München > Klinik und Poliklinik für Radiologie ; Medizin > Klinikum der LMU München > Urologische Klinik und Poliklinik
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1619-7070
• Sprache: Englisch