[ <sup>18</sup>F]FAPI-42 PET/CT in differentiated thyroid cancer: diagnostic performance, uptake values, and comparison with 2-[ <sup>18</sup>F]FDG PET/CT

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Abstract

Purpose

This study aimed to assess the diagnostic performance of [ ¹⁸F]FAPI-42 PET/CT and compare it with that of 2-[ ¹⁸F]FDG PET/CT in patients with differentiated thyroid cancer (DTC) with biochemical elevations in Tg or anti-Tg antibodies.

Methods

A total of 42 patients with DTC with biochemical elevations in Tg or anti-Tg antibodies underwent [ ¹⁸F]FAPI-42 PET/CT as part of this study; of which, 11 additionally underwent 2-[ ¹⁸F]FDG PET/CT within 7 days. Images were semi-quantitatively and visually interpreted, and the quantity, location, and uptake values of lesions were noted. The diagnostic capacity of [ ¹⁸F]FAPI-42 PET/CT and biomarkers affecting the uptake of [ ¹⁸F]FAPI-42 were evaluated. In addition, the diagnostic performance and uptake of [ ¹⁸F]FAPI-42 and 2-[ ¹⁸F]FDG were compared, and the correlation between lesion diameter and quantitative parameters was investigated.

Results

A total of 161 lesions were detected in 27 (64%) patients on [ ¹⁸F]FAPI-42 PET/CT. FAPI-positive local recurrence showed the highest uptake intensity, followed by lymphatic, other site-associated (bone and pleura), and pulmonary lesions (mean SUV _max, 4.7 versus 3.7 versus 3.0 versus 2.2, respectively; P < 0.0001). The levels of TSH, Tg, and Tg-Ab did not affect the uptake value of lesions (median SUV _max: 2.4 versus 3.2, P = 0.56; 2.9 versus 2.4, P = 0.0935; 2.8 versus 2.6, P = 0.0525, respectively). A total of 90 positive lesions were detected in 7 patients using both modalities. All positive lesions showed statistically higher uptake of 2-[ ¹⁸F]FDG than that of [ ¹⁸F]FAPI-42 (SUV _max, 2.6 versus 2.1; P = 0.026). However, the SUV _max of [ ¹⁸F]FAPI-42 was higher than that of 2-[ ¹⁸F]FDG in local recurrences and lymphatic lesions (SUV _max, 4.2 versus 2.9 and 3.9 versus 3.4, respectively; P > 0.05).

Conclusion

[ ¹⁸F]FAPI-42 can be used for detecting lesions and reflecting FAP expression during local recurrence and metastasis in patients with DTC with biochemical elevations in Tg or anti-Tg antibodies. The diagnostic performance of [ ¹⁸F]FAPI-42 PET/CT is comparable with that of 2-[ ¹⁸F]FDG PET/CT in such patients.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00259-022-06067-2.

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Author and article information

Contributors

Wei Fu: fuwei19700513@163.com

Jingsong Mao: maojingsong163@163.com

Journal

Journal ID (nlm-ta): Eur J Nucl Med Mol Imaging

Journal ID (iso-abbrev): Eur J Nucl Med Mol Imaging

Title: European Journal of Nuclear Medicine and Molecular Imaging

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1619-7070

ISSN (Electronic): 1619-7089

Publication date (Electronic): 10 December 2022

Publication date PMC-release: 10 December 2022

Publication date (Print): 2023

Volume: 50

Issue: 4

Pages: 1205-1215

Affiliations

[1 ]GRID grid.443385.d, ISNI 0000 0004 1798 9548, Department of Nuclear Medicine, Affiliated Hospital, , Guilin Medical University, ; Guilin, China

[2 ]GRID grid.443385.d, ISNI 0000 0004 1798 9548, Department of Vascular Intervention, Affiliated Hospital, , Guilin Medical University, ; Guilin, China

[3 ]Xiamen Key Laboratory of Endocrine-Related Cancer Precision Medicine, Xiamen, 361101 China

Article

Publisher ID: 6067

DOI: 10.1007/s00259-022-06067-2

PMC ID: 9931817

PubMed ID: 36495325

SO-VID: 5c8b42a8-6dff-4405-98f5-9ac5f33b01de

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 9 September 2022

Date accepted : 28 November 2022

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: [18f]fapi-42,2-[18f]fdg,differentiated thyroid cancer,pet/ct

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: [18f]fapi-42, 2-[18f]fdg, differentiated thyroid cancer, pet/ct

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