First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls
<b>Background/Objectives:</b> Over the past four years, <sup>68</sup>Ga-fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) has been established at a tertiary cancer care facility in Jordan. This retrospective study aims to...
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MDPI AG
2025-01-01
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| author | Akram Al-Ibraheem Ahmed Saad Abdlkadir Ula Al-Rasheed Dhuha Al-Adhami Feras Istatieh Farah Anwar Marwah Abdulrahman Rula Amarin Issa Mohamad Asem Mansour |
| author_facet | Akram Al-Ibraheem Ahmed Saad Abdlkadir Ula Al-Rasheed Dhuha Al-Adhami Feras Istatieh Farah Anwar Marwah Abdulrahman Rula Amarin Issa Mohamad Asem Mansour |
| author_sort | Akram Al-Ibraheem |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Over the past four years, <sup>68</sup>Ga-fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) has been established at a tertiary cancer care facility in Jordan. This retrospective study aims to explore tracer uptake metrics across various epithelial neoplasms, identify diagnostic pitfalls associated with <sup>68</sup>Ga-FAPI PET/CT, and evaluate the influence of <sup>68</sup>Ga-FAPI PET/CT staging results on changes in therapeutic intent compared to gold standard molecular imaging modalities. <b>Methods:</b> A total of 48 patients with biopsy-confirmed solid tumors underwent 77 <sup>68</sup>Ga-FAPI PET/CT examinations for molecular imaging assessment, encompassing neoplasms originating from the gastrointestinal tract, head and neck, hepatobiliary system, pancreas, breast, and lung. <b>Results:</b> Notably, pancreaticobiliary tumors exhibited the highest tracer uptake, with mean maximum standardized uptake values (SUVmax) and tumor-to-background ratios (TBR) surpassing 10. A comparative sub-analysis of <sup>68</sup>Ga-FAPI PET metrics in 20 treatment-naïve patients revealed a significant correlation between <sup>68</sup>Ga-FAPI uptake metrics and tumor grade (Spearman’s rho 0.83; <i>p</i> = 0.00001). Importantly, the results from <sup>68</sup>Ga-FAPI PET/CT influenced treatment decisions in 35.5% of the cases, primarily resulting in an escalation of management plans. A total of 220 diagnostic challenges were identified across 88.3% of the scans, predominantly within the musculoskeletal system, attributed to degenerative changes (99 observations). <b>Conclusions:</b> This comprehensive analysis highlights the potential significance of <sup>68</sup>Ga-FAPI PET/CT in oncological imaging and treatment strategy, while also emphasizing the necessity for meticulous interpretation to mitigate diagnostic challenges. |
| format | Article |
| id | doaj-art-ddc56998d40e4417b25fe0a25da22a44 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-ddc56998d40e4417b25fe0a25da22a442025-01-24T13:29:09ZengMDPI AGDiagnostics2075-44182025-01-0115221810.3390/diagnostics15020218First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and PitfallsAkram Al-Ibraheem0Ahmed Saad Abdlkadir1Ula Al-Rasheed2Dhuha Al-Adhami3Feras Istatieh4Farah Anwar5Marwah Abdulrahman6Rula Amarin7Issa Mohamad8Asem Mansour9Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Nuclear Medicine, Warith International Cancer Institute, Karbala 56001, IraqDepartment of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Radiation Oncology, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, JordanDepartment of Diagnostic Radiology, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan<b>Background/Objectives:</b> Over the past four years, <sup>68</sup>Ga-fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) has been established at a tertiary cancer care facility in Jordan. This retrospective study aims to explore tracer uptake metrics across various epithelial neoplasms, identify diagnostic pitfalls associated with <sup>68</sup>Ga-FAPI PET/CT, and evaluate the influence of <sup>68</sup>Ga-FAPI PET/CT staging results on changes in therapeutic intent compared to gold standard molecular imaging modalities. <b>Methods:</b> A total of 48 patients with biopsy-confirmed solid tumors underwent 77 <sup>68</sup>Ga-FAPI PET/CT examinations for molecular imaging assessment, encompassing neoplasms originating from the gastrointestinal tract, head and neck, hepatobiliary system, pancreas, breast, and lung. <b>Results:</b> Notably, pancreaticobiliary tumors exhibited the highest tracer uptake, with mean maximum standardized uptake values (SUVmax) and tumor-to-background ratios (TBR) surpassing 10. A comparative sub-analysis of <sup>68</sup>Ga-FAPI PET metrics in 20 treatment-naïve patients revealed a significant correlation between <sup>68</sup>Ga-FAPI uptake metrics and tumor grade (Spearman’s rho 0.83; <i>p</i> = 0.00001). Importantly, the results from <sup>68</sup>Ga-FAPI PET/CT influenced treatment decisions in 35.5% of the cases, primarily resulting in an escalation of management plans. A total of 220 diagnostic challenges were identified across 88.3% of the scans, predominantly within the musculoskeletal system, attributed to degenerative changes (99 observations). <b>Conclusions:</b> This comprehensive analysis highlights the potential significance of <sup>68</sup>Ga-FAPI PET/CT in oncological imaging and treatment strategy, while also emphasizing the necessity for meticulous interpretation to mitigate diagnostic challenges.https://www.mdpi.com/2075-4418/15/2/218fibroblast activation proteinFAPIPET/CTdiagnostic pitfallstherapeutic managementmanagement |
| spellingShingle | Akram Al-Ibraheem Ahmed Saad Abdlkadir Ula Al-Rasheed Dhuha Al-Adhami Feras Istatieh Farah Anwar Marwah Abdulrahman Rula Amarin Issa Mohamad Asem Mansour First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls Diagnostics fibroblast activation protein FAPI PET/CT diagnostic pitfalls therapeutic management management |
| title | First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls |
| title_full | First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls |
| title_fullStr | First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls |
| title_full_unstemmed | First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls |
| title_short | First Clinical Experience of <sup>68</sup>Ga-FAPI PET/CT in Tertiary Cancer Center: Identifying Pearls and Pitfalls |
| title_sort | first clinical experience of sup 68 sup ga fapi pet ct in tertiary cancer center identifying pearls and pitfalls |
| topic | fibroblast activation protein FAPI PET/CT diagnostic pitfalls therapeutic management management |
| url | https://www.mdpi.com/2075-4418/15/2/218 |
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