Prospective comparison of 68Ga-FAPI-04 and 18F-FDG PET/CT for tumor staging in nasopharyngeal carcinoma

Haoyuan Ding; Juan Liang; Lin Qiu; Tingting Xu; Liang Cai; Qiang Wan; Li Wang; Ya Liu; Yue Chen

doi:10.3389/fonc.2022.1047010

Prospective comparison of ⁶⁸Ga-FAPI-04 and ¹⁸F-FDG PET/CT for tumor staging in nasopharyngeal carcinoma

Front Oncol. 2022 Dec 8:12:1047010. doi: 10.3389/fonc.2022.1047010. eCollection 2022.

Authors

Haoyuan Ding^{1

2

3

4}, Juan Liang⁵, Lin Qiu^{2

3

4}, Tingting Xu^{2

3

4}, Liang Cai^{2

3

4}, Qiang Wan^{2

3

4}, Li Wang^{2

3

4}, Ya Liu^{2

3

4}, Yue Chen^{1

2

3

4}

Affiliations

¹ Jinan University, Guangzhou, Guangdong, China.
² Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
³ Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China.
⁴ Institute of Nuclear Medicine, Southwest Medical University, Luzhou, Sichuan, China.
⁵ Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Abstract

Purpose: To explore the difference in the effectiveness of gallium-68 fibroblast activation protein inhibitor (⁶⁸Ga-FAPI-04) PET/CT and fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) PET/CT for the initial staging of patients with nasopharyngeal carcinoma (NPC).

Methods: The Affiliated Hospital of Southwest Medical University hosted this single-center prospective investigation (Clinical Trials registration No.ChiCTR2100044131) between March 2020 and September 2021. Within a week, all subjects underwent MR scans, ⁶⁸Ga-FAPI-04 PET/CT, and ¹⁸F-FDG PET/CT in order. The effectiveness of medical staging employing ⁶⁸Ga-FAPI-04 and ¹⁸F-FDG PET/CT was compared.

Results: Twenty-eight patients with primary NPC were evaluated (mean age53 ± 11 years). ⁶⁸Ga-FAPI-04 PET/CT indicated an elevated recognition rate for diagnosing primary tumors (28/28 [100%] vs. 27/28 [96%]) and lymph node metastases (263/285 [92%] vs. 228/285 [80%]), but a lower detection rate for distant metastases (5/7 [71%] vs. 7/7 [100%]) compared with ¹⁸F-FDG PET/CT. A significant association between the maximum standard uptake value (SUVmax) of ¹⁸F-FDG PET and ⁶⁸Ga-FAPI-04 PET was found in the primary cancers (r = 0.691, p < 0.001). In comparison to ¹⁸F-FDG PET/CT, ⁶⁸Ga-FAPI-04 PET/CT upstaged the T stage in five patients while downstaging the N stage in seven patients. ⁶⁸Ga-FAPI-04 PET/CT corrected the overall staging of five patients on¹⁸F-FDG PET/CT.

Conclusion: ⁶⁸Ga-FAPI-04 PET/CT is preferable to ¹⁸F-FDG PET/CT for NPC staging in terms of the detection efficiency for primary tumors and lymph node metastasis. This is especially true when evaluating the primary cancer and any spread to contiguous tissues. It is possible to improve the staging assessment of NPC by using ⁶⁸Ga-FAPI-04 PET/CT in conjunction with ¹⁸F-FDG PET/CT.

Keywords: 18F-FDG; 68Ga-FAPI-04; PET/CT; nasopharyngeal carcinoma; tumor staging.