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Superiority of 68Ga-FAPI PET/CT scan in detecting additional lesions compared to 18FDG PET/CT scan in breast cancer

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Abstract

Purpose

We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect additional lesions in breast cancer patients that may affect further chemotherapy options.

Methods

A total of 48 patients with breast cancer underwent concurrent 68Ga-FAPI-04 and 18FDG PET/CT regardless of whether they had received chemotherapy or not in the last month before imaging. Both modalities were compared according to various parameters: clinical/pathological features, number of lesions detected, activity uptake (SUVmax), and the effect on the evaluation of response to treatment in the post-chemotherapy group.

Results

This retrospective study included 48 patients with breast cancer (mean age 53.3 ± 11.7 years; IDC 89.6%; ILC 10.4%). In the comparison of both modalities, no statistical significance was obtained in terms of the pathological characteristics of the patients. More lesions were demonstrated in all categorized regions in 68Ga-FAPI PET/CT imaging with higher uptake values compared to 18FDG PET/CT in this study. In the treatment response evaluation of the post-chemotherapy group, 12 cases (12/24) who were evaluated as PMR, CMR, or SD according to 18FDG PET/CT results were later accepted as PD due to newly detected lesions in complementary 68Ga-FAPI PET/CT imaging and treatment of patients was managed accordingly by clinicians.

Conclusion

It was determined that 68Ga-FAPI PET/CT was superior to 18FDG PET/CT in terms of accuracy and it was thought that 68Ga-FAPI PET/CT could be utilized as an additional complementary imaging to 18FDG PET/CT. Moreover, 68Ga-FAPI PET/CT, with its significant theranostic potential, could become a key element in predicting the pathological response of breast cancer patients in further researches.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Gaziantep University, 27310, Sahinbey, Gaziantep, Turkey

    Umut Elboga, Ertan Sahin, Yusuf Burak Cayirli, Ufuk Cimen, Vuslat Mumcu & Y. Zeki Çelen

  2. Department of Oncology, Gaziantep University, Gaziantep, Turkey

    Tulay Kus, Havva Yesil Cinkir, Fatih Teker, Ozlem Nuray Sever & Aydin Aytekin

  3. Department of Oncology, Medical Park Private Hospital, Gaziantep, Turkey

    Gokmen Aktas

  4. Department of Pathology, Gaziantep University, Gaziantep, Turkey

    Evren Uzun

  5. Department of General Surgery, Gaziantep University, Gaziantep, Turkey

    Alper Aytekin & Latif Yilmaz

  6. Department of Chemistry, Moltek Inc., İstanbul, Turkey

    Benan Kilbas

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  1. Umut Elboga
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Elboga, U., Sahin, E., Kus, T. et al. Superiority of 68Ga-FAPI PET/CT scan in detecting additional lesions compared to 18FDG PET/CT scan in breast cancer. Ann Nucl Med 35, 1321–1331 (2021). https://doi.org/10.1007/s12149-021-01672-x

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