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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 2/2022

09.07.2021 | Original Article

Increased uptake of 68Ga-DOTA-FAPI-04 in bones and joints: metastases and beyond

verfasst von: Chunxia Qin, Yangmeihui Song, Xi Liu, Yongkang Gai, Qingyao Liu, Weiwei Ruan, Fang Liu, Fan Hu, Xiaoli Lan

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2022

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Abstract

Purpose

To describe the uptake of 68Gallium-labelled fibroblast activation protein inhibitor (68Ga-FAPI) in the bones and joints for better understanding of the role of 68Ga-FAPI PET in benign and malignant bone lesions and joint diseases.

Methods

All 129 68Ga-FAPI PET/MR or PET/CT scans from June 1, 2020, to February 20, 2021, performed at our PET center were retrospectively reviewed. Foci of elevated 68Ga-FAPI uptake in the bones and joints were identified. All lesions were divided into malignant and benign diseases. Benign lesions included osteofibrous dysplasia, periodontitis, degenerative bone diseases, arthritis, and other inflammatory or trauma-related abnormalities. The number, locations, and SUVmax of all lesions were recorded and analyzed. The detectability of 68Ga-FAPI PET and 18F-FDG PET in patients who had two scans was also compared.

Results

Elevated uptake of 68Ga-FAPI in/around the bones and joints was found in 82 cases (63.57%). A total of 295 lesions were identified, including 94 (31.9%) malignant lesions (all were metastases) and 201 (68.1%) benign lesions. The benign lesions consisted of 13 osteofibrous dysplasia, 48 degenerative bone disease, 33 periodontitis, 56 arthritis, and 51 other inflammatory or trauma-related abnormalities. The spine, shoulder joint, alveolar ridge, and pelvis were the most commonly involved locations. Bone metastases were mainly distributed in the spine, pelvis, and ribs. Among benign diseases, periodontitis and arthritis are site-specific. The mean SUVmax of bone metastases was significantly higher than that of benign diseases (7.14 ± 4.33 vs. 3.57 ± 1.60, p < 0.001), but overlap existed. The differences in SUVmax among subgroups of benign diseases were statistically significant (p < 0.001), with much higher uptake in periodontitis (4.45 ± 1.17). 68Ga-FAPI PET identified much more lesions than 18F-FDG PET (104 vs. 48) with higher uptake value.

Conclusion

68Ga-FAPI accumulated in both bone metastases and some benign diseases of the bones and joints. Although the uptake of 68Ga-FAPI was often higher in bone metastases, this finding cannot be used to distinguish between benign and malignant lesions. 68Ga-FAPI PET also has the potential to locate and evaluate the extent of both malignant tumor and benign diseases in bones and joints.

Trial registration

NCT04554719, NCT04605939. Registered September 8, 2020 and October 25, 2020—retrospectively registered, http://​clinicaltrails.​gov/​show/​NCT04554719; http://​clinicaltrails.​gov/​show/​NCT04605939
Literatur
5.
Zurück zum Zitat Toms J, Kogler J, Maschauer S, Daniel C, Schmidkonz C, Kuwert T, et al. Targeting fibroblast activation protein: radiosynthesis and preclinical evaluation of an (18)F-labeled FAP inhibitor. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://doi.org/10.2967/jnumed.120.242958. Toms J, Kogler J, Maschauer S, Daniel C, Schmidkonz C, Kuwert T, et al. Targeting fibroblast activation protein: radiosynthesis and preclinical evaluation of an (18)F-labeled FAP inhibitor. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://​doi.​org/​10.​2967/​jnumed.​120.​242958.
6.
Zurück zum Zitat Watabe T, Liu Y, Kaneda-Nakashima K, Shirakami Y, Lindner T, Ooe K, et al. Theranostics targeting fibroblast activation protein in the tumor stroma: (64)Cu and (225)Ac labelled FAPI-04 in pancreatic cancer xenograft mouse models. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2019. https://doi.org/10.2967/jnumed.119.233122. Watabe T, Liu Y, Kaneda-Nakashima K, Shirakami Y, Lindner T, Ooe K, et al. Theranostics targeting fibroblast activation protein in the tumor stroma: (64)Cu and (225)Ac labelled FAPI-04 in pancreatic cancer xenograft mouse models. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2019. https://​doi.​org/​10.​2967/​jnumed.​119.​233122.
21.
Zurück zum Zitat Luo Y, Pan Q, Yang H, Peng L, Zhang W, Li F. Fibroblast activation protein targeted PET/CT with (68)Ga-FAPI for imaging IgG4-related disease: comparison to (18)F-FDG PET/CT. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://doi.org/10.2967/jnumed.120.244723. Luo Y, Pan Q, Yang H, Peng L, Zhang W, Li F. Fibroblast activation protein targeted PET/CT with (68)Ga-FAPI for imaging IgG4-related disease: comparison to (18)F-FDG PET/CT. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://​doi.​org/​10.​2967/​jnumed.​120.​244723.
27.
Zurück zum Zitat Tang YH, Yue ZS, Zheng WJ, Shen HF, Zeng LR, Hu ZQ, et al. 4-Phenylbutyric acid presents therapeutic effect on osteoarthritis via inhibiting cell apoptosis and inflammatory response induced by endoplasmic reticulum stress. Biotechnol Appl Biochem. 2018;65:540–6. https://doi.org/10.1002/bab.1642.CrossRefPubMed Tang YH, Yue ZS, Zheng WJ, Shen HF, Zeng LR, Hu ZQ, et al. 4-Phenylbutyric acid presents therapeutic effect on osteoarthritis via inhibiting cell apoptosis and inflammatory response induced by endoplasmic reticulum stress. Biotechnol Appl Biochem. 2018;65:540–6. https://​doi.​org/​10.​1002/​bab.​1642.CrossRefPubMed
34.
Zurück zum Zitat Koerber SA, Staudinger F, Kratochwil C, Adeberg S, Haefner MF, Ungerechts G, et al. The role of FAPI-PET/CT for patients with malignancies of the lower gastrointestinal tract - first clinical experience. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://doi.org/10.2967/jnumed.119.237016 Koerber SA, Staudinger F, Kratochwil C, Adeberg S, Haefner MF, Ungerechts G, et al. The role of FAPI-PET/CT for patients with malignancies of the lower gastrointestinal tract - first clinical experience. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2020. https://​doi.​org/​10.​2967/​jnumed.​119.​237016
35.
Zurück zum Zitat Windisch P, Zwahlen DR, Koerber SA, Giesel FL, Debus J, Haberkorn U, et al. Clinical results of fibroblast activation protein (FAP) specific PET and implications for radiotherapy planning: systematic review. Cancers (Basel). 2020;12. https://doi.org/10.3390/cancers12092629 Windisch P, Zwahlen DR, Koerber SA, Giesel FL, Debus J, Haberkorn U, et al. Clinical results of fibroblast activation protein (FAP) specific PET and implications for radiotherapy planning: systematic review. Cancers (Basel). 2020;12. https://​doi.​org/​10.​3390/​cancers12092629
Metadaten
Titel
Increased uptake of 68Ga-DOTA-FAPI-04 in bones and joints: metastases and beyond
verfasst von
Chunxia Qin
Yangmeihui Song
Xi Liu
Yongkang Gai
Qingyao Liu
Weiwei Ruan
Fang Liu
Fan Hu
Xiaoli Lan
Publikationsdatum
09.07.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2022
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-021-05472-3

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