68Ga-FAPI-04 PET/CT, a new step in breast cancer imaging: a comparative pilot study with the 18F-FDG PET/CT

• Published in: Annals of nuclear medicine Vol. 35; no. 6; pp. 744 - 752
• Main Authors: Kömek, Halil, Can, Canan, Güzel, Yunus, Oruç, Zeynep, Gündoğan, Cihan, Yildirim, Özgen Ahmet, Kaplan, İhsan, Erdur, Erkan, Yıldırım, Mehmet Serdar, Çakabay, Bahri
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.06.2021; Springer Nature B.V
• Subjects: Bone imaging; Bone tumors; Breast cancer; Computed tomography; Fluorine isotopes; Imaging; Imaging techniques; Lesions; Liver; Lungs; Lymph nodes; Lymphatic system; Medical imaging; Medicine; Medicine & Public Health; Metastases; Metastasis; Neuroimaging; Nuclear Medicine; Original Article; Positron emission; Positron emission tomography; Radiology; Sensitivity analysis; Statistical analysis; Tomography; Tumors; Ga-FAPI; Breast Cancer; F-FDG; PET/CT
• ISSN: 0914-7187; 1864-6433; 1864-6433
• DOI: 10.1007/s12149-021-01616-5

Aim We aimed to compare the roles of 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT in the evaluation of primary tumor and metastases in primary and recurrent breast cancer. Materials and method Twenty female patients with histopathologically confirmed primary and recurrent breast cancer were included in the prospective study. All patients underwent FDG and FAPI PET/CT imaging in the same week. The number of primary and metastatic lesions, SUV max values, and tumor-to-background ratios (TBR) were recorded from both scans. Data obtained were statistically compared. Results FAPI PET/CT was superior to FDG in detecting breast lesions, as well as hepatic, bone, lymph node, and cerebral metastases in terms of patient- and lesion-based assessments. The sensitivity and specificity of FAPI in detecting primary breast lesions were 100% and 95.6%, respectively, while the sensitivity and specificity of FDG were 78.2% and 100%, respectively. The SUV max values of primary breast tumors, lymph nodes, lung metastases, and bone metastases were significantly higher on FAPI imaging than FDG imaging ( p  < 0.05). However, SUV max values of hepatic metastases did not exhibit a statistically significant difference between two imaging techniques ( p  > 0.05). Also, FAPI imaging yielded significantly higher TBR in breast lesions as well as hepatic, bone, brain and lung metastases compared to FDG ( p  < 0.05). Conclusion 68  Ga-FAPI-04 PET/CT is superior to 18 F-FDG PET/CT in detecting the primary tumor in patients with breast cancer with its high sensitivity, high SUV max , and high TBR. 68  Ga-FAPI-04 PET/CT is also superior to 18 F-FDG PET/CT in detecting lymph node, hepatic, bone, and cerebral metastases because it has lower background activity and higher uptake in subcentimetric lesions.