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@ARTICLE{Wegen:916866,
author = {Wegen, Simone and van Heek, Lutz and Linde, Philipp and
Claus, Karina and Akuamoa-Boateng, Dennis and Baues,
Christian and Sharma, Shachi Jenny and Schomäcker, Klaus
and Fischer, Thomas and Roth, Katrin Sabine and Klußmann,
Jens Peter and Marnitz, Simone and Drzezga, Alexander and
Kobe, Carsten},
title = {{H}ead-to-{H}ead {C}omparison of
[68 {G}a]{G}a-{FAPI}-46-{PET}/{CT} and
[18{F}]{F}-{FDG}-{PET}/{CT} for {R}adiotherapy {P}lanning in
{H}ead and {N}eck {C}ancer},
journal = {Molecular imaging $\&$ biology},
volume = {24},
number = {6},
issn = {1536-1632},
address = {Cham},
publisher = {Springer Nature Switzerland},
reportid = {FZJ-2023-00158},
pages = {986 - 994},
year = {2022},
abstract = {Introduction: In head and neck cancers (HNCs), fibroblast
activation protein (FAP) is expressed by cancer-associated
fibroblasts (CAFs) in the tumor microenvironment.
Preliminary evidence suggests that detection and staging is
feasible with positron emission tomography (PET/CT) imaging
using [68 Ga]-radiolabeled inhibitors of FAP ([68
Ga]Ga-FAPI-46) in HNCs. This study aims to compare [68
Ga]Ga-FAPI-46 PET/CT and [18F]-fluorodeoxy-D-glucose
([18F]F-FDG) PET/CT with a focus on improved target volume
definition and radiotherapy planning in patients with HNC
referred for chemoradiation.Methods: A total of 15 patients
with HNCs received both [68 Ga]Ga-FAPI-46 PET/CT and
[18F]F-FDG PET/CT with a thermoplastic mask, in addition to
initial tumor staging by conventional imaging with
contrast-enhanced CT and/or MRI. Mean intervals between
FAPI/FDG and FAPI/conventional imaging were 4 ± 20 and 17
± 18 days, respectively. Location and number of suspicious
lesions revealed by the different procedures were recorded.
Subsequently, expert-generated gross tumor volumes (GTVs)
based on conventional imaging were compared to those based
on [18F]F-FDG and [68 Ga]Ga-FAPI-46 PET/CT to measure the
impact on subsequent radiation planning.Results: All
patients had focal FAPI uptake above background in tumor
lesions. Compared to FDG, tumor uptake (median SUVmax 10.2
vs. 7.3, p = 0.008) and tumor-to-background ratios were
significantly higher with FAPI than with FDG (SUVmean liver:
9.3 vs. 3.2, p < 0.001; SUVmean bloodpool: 6.9 vs. 4.0, p <
0.001). A total of 49 lesions were recorded. Of these, 40
$(82\%)$ were FDG+ and 41 $(84\%)$ were FAP+. There were 5
$(10\%)$ FAP+/FDG- lesions and 4 $(8\%)$ FAP-/FDG+ lesions.
Volumetrically, a significant difference was found between
the GTVs (median 57.9 ml in the FAPI-GTV, 42.5 ml in the
FDG-GTV, compared to 39.2 ml in the conventional-GTV).
Disease stage identified by FAPI PET/CT was mostly
concordant with FDG PET/CT. Compared to conventional
imaging, five patients $(33\%)$ were upstaged following
imaging with FAPI and FDG PET/CT.Conclusion: We demonstrate
that [68 Ga]Ga-FAPI-46 -PET/CT is useful for detecting tumor
lesions in patients with HNCs. There is now a need for
prospective randomized studies to confirm the role of [68
Ga]Ga-FAPI-46 PET/CT in relation to [18F]F-FDG PET/CT in
HNCs and to evaluate its impact on clinical
outcome.Keywords: FAPI; FDG/PET; Head and neck cancer;
PET-based; Radiotherapy planning.},
cin = {INM-2},
ddc = {570},
cid = {I:(DE-Juel1)INM-2-20090406},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {35771317},
UT = {WOS:000819277600001},
doi = {10.1007/s11307-022-01749-7},
url = {https://juser.fz-juelich.de/record/916866},
}