The Role of 68 Ga-FAPI PET/CT in Detection of Metastatic Lobular Breast Cancer

Clin Nucl Med. 2023 Mar 1;48(3):228-232. doi: 10.1097/RLU.0000000000004540. Epub 2023 Jan 14.

Abstract

Purpose: Invasive lobular breast cancer (ILC) may be hard to detect using conventional imaging modalities and usually shows less avidity to 18 F-FDG PET/CT. 68 Ga-fibroblast activation protein inhibitor (FAPI) PET/CT has shown promising results in detecting non- 18 F-FDG-avid cancers. We aimed to assess the feasibility of detecting metastatic disease in patients with non- 18 F-FDG-avid ILC.

Methods: This prospective study included patients with metastatic ILC, infiltrative to soft tissues, which was not 18 F-FDG avid. The patients underwent 68 Ga-FAPI PET/CT for evaluation, which was correlated with the fully diagnostic CT performed at the same time.

Results: Seven women (aged 57 ± 10 years) were included. Among the 30 organs and structures found to be involved by tumor, the number of findings observed by FAPI PET/CT was significantly higher than that observed by CT alone ( P = 0.022), especially in infiltrative soft tissue and serosal locations.

Conclusions: This small pilot trial suggests a role for 68 Ga-FAPI PET/CT in ILC, which needs to be confirmed by subsequent trials.

MeSH terms

  • Breast Neoplasms* / diagnostic imaging
  • Carcinoma, Lobular* / diagnostic imaging
  • Female
  • Fluorodeoxyglucose F18
  • Gallium Radioisotopes
  • Humans
  • Positron Emission Tomography Computed Tomography
  • Prospective Studies

Substances

  • Fluorodeoxyglucose F18
  • Gallium-68
  • abamectin
  • Gallium Radioisotopes