nach oben

European Journal of Nuclear Medicine and Molecular Imaging

10.05.2024 | Original Article

A head-to-head comparison of [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT in patients with nasopharyngeal carcinoma: a single-center, prospective study

verfasst von: Jieling Zheng, Guochang Wang, Qian Ru, Yun Yang, Li Su, Wenlong Lv, Chunlin Ke, Peirong Wang, Xiaohui Liu, Li Zhang, Feng Liu, Weibing Miao

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We aimed to compare the staging efficiency of [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT in nasopharyngeal carcinoma (NPC) patients.

Methods

Thirty-nine patients with pathologically confirmed NPC were enrolled in this prospective study. Each patient underwent paired [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT on 2 successive days. The accuracy of two PET/CT for assessing T, N, and M stages was compared by using head-and-neck MRI, histopathologic diagnosis and follow-up results as reference standards. The radiotracer uptake derived from two PETs was also compared.

Results

For treatment-naïve patients, [⁶⁸Ga]Ga-DOTATATE PET/CT showed identical sensitivity for the primary tumours but clearer tumor delineation induced by higher tumour-to-background (TBR) ratio (19.1 ± 8.7 vs. 12.4 ± 7.7, P = 0.003), compared with [⁶⁸Ga]Ga-FAPI PET/CT. Regarding cervical lymph node (CLN) metastases, [⁶⁸Ga]Ga-DOTATATE PET had significantly better sensitivity and accuracy based on neck sides (98% vs. 82%, P < 0.001; 99% vs. 88% P = 0.008), neck levels (98% vs. 78%, 99% vs. 97%; both P < 0.001) and individual nodes (89% vs. 56%, 91% vs. 76%; both P < 0.001), and higher TBR (8.1 ± 4.1 vs. 6.3 ± 3.7, P < 0.001). Additionally, [⁶⁸Ga]Ga-DOTATATE PET/CT revealed higher sensitivity and accuracy for distant metastases (96% vs. 53%, 95% vs. 52%; both P < 0.001), particularly in bone metastases (99% vs. 49%, 97% vs. 49%; both P < 0.001). For post-treatment patients, [⁶⁸Ga]Ga-DOTATATE PET/CT identified one more true-negative case than [⁶⁸Ga]Ga-FAPI PET/CT.

Conclusion

[⁶⁸Ga]Ga-DOTATATE PET/CT performed better than [⁶⁸Ga]Ga-FAPI PET/CT in visualizing the primary tumours, detecting the metastatic lesions and identifying the local recurrence, suggesting [⁶⁸Ga]Ga-DOTATATE PET/CT may be superior to [⁶⁸Ga]Ga-FAPI PET/CT for NPC staging.

Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet. 2019;394:394. https://doi.org/10.1016/S0140-6736(19)30956-0.CrossRef

Hudgins PA, Baugnon KL. Head and Neck: Skull Base Imaging. Neurosurgery. 2018;82:255–67. https://doi.org/10.1093/neuros/nyx492.CrossRefPubMed

Tang LL, Chen WQ, Xue WQ, He YQ, Zheng RS, Zeng YX, et al. Global trends in incidence and mortality of nasopharyngeal carcinoma. Cancer Lett. 2016;374:22–30. https://doi.org/10.1016/j.canlet.2016.01.040.CrossRefPubMed

Young LS, Dawson CW. Epstein-Barr virus and nasopharyngeal carcinoma. Chin J Cancer. 2014; 33: 581 − 90. https://doi:10.5732/cjc.014.10197.

Lee AWM, Ng WT, Chan JYW, Corry J, Mäkitie A, Mendenhall WM et al. Management of locally recurrent nasopharyngeal carcinoma. Cancer Treat Rev. 2019;79:101890. https://doi.org/10. 1016/j. ctrv. 2019. 101890.

Lai V, Khong PL. Updates on MR imaging and ¹⁸F-FDG PET/CT imaging in nasopharyngeal carcinoma. Oral Oncol. 2014;50(6):539–48. https://doi.org/10.1016/j.oraloncology.2013.05.005.CrossRefPubMed

Lee SH, Huh SH, Jin SM, Rho YS, Yoon DY, Park CH. Diagnostic value of only ¹⁸F-fluorodeocyglucose positron emission tomography/computed tomography-positive lymph nodes in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg. 2012;147:692–8. https://doi.org/10.1177/0194599812443040.CrossRefPubMed

Tsai MC, Shu YC, Hsu CC, Lin CK, Lee JC, Chu YH, et al. False positive finding of retropharyngeal lymph node recurrence in both fluorine (18)FDG PET and MRI in a patient with nasopharyngeal carcinoma. Head Neck. 2016;38:E84–6. https://doi.org/10.1002/hed.24205.CrossRefPubMed

Tang LL, Chen YP, Chen CB, Chen MY, Chen NY, Chen XZ, The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma.Cancer Commun (Lond), 2021;41:1195 − 227. https://doi:10.1002/cac2.12218.

10.

OuYang PY, Liu ZQ, Lin QG, He Y, Guo ZX, Yao WY, et al. Benefit of [¹⁸F] FDG PET/CT in the diagnosis and salvage treatment of recurrent nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2023;50:881 − 91. https://doi:10.1007/s00259-022-06020-3.

11.

Comoretto M, Balestreri L, Borsatti E, Cimitan M, Franchin G, Lise M. Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology. 2008;249:203 − 11. https://doi:10.1148/radiol.2491071753.

12.

Qin C, Liu F, Huang J, Ruan W, Liu Q, Gai Y, et al. A head-to-head comparison of ⁶⁸Ga-DOTA-FAPI-04 and ¹⁸F-FDG PET/MR in patients with nasopharyngeal carcinoma: a prospective study. Eur J Nucl Med Mol Imaging. 2021;48:3228-37. https://doi:10.1007/s00259-021-05255-w.

13.

Zhao L, Pang Y, Zheng H, Han C, Gu J, Sun L, et al. Clinical utility of [⁶⁸Ga]Ga-labeled fbroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography for primary staging and recurrence detection in nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2021;48:3606-17. https://doi:10.1007/s00259-021-05336-w.

14.

Zheng J, Liu F, Lin K, Zhang L, Huang N, Zheng W, et al. [⁶⁸Ga]GaFAPI PET/CT improves the T staging of patients with newly diagnosed nasopharyngeal carcinoma: a comparison with [¹⁸F]FFDG. Mol Imaging Biol. 2022;24:973–85. https://doi.org/10.1007/s11307-022-01748-8.CrossRefPubMed

15.

Loh KS, Waser B, Tan LK, Ruan RS, Stauffer E, Reubi JC. Somatostatin receptors in nasopharyngeal carcinoma. Virchows Arch. 2002;441:444–8. https://doi.org/10.1007/s00428-002-0693-y.CrossRefPubMed

16.

Schartinger VH, Dudás J, Url C, Reinold S, Virgolini IJ, Kroiss A, et al. (68)Ga-DOTA (0)-Tyr (3)-octreotide positron emission tomography in nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2015;42:20–4. https://doi.org/10.1007/s00259-014-2905-5.CrossRefPubMed

17.

Khor LK, Loi HY, Sinha AK, Tong KT, Goh BC, Loh KS, et al. (68)Ga-DOTA-peptide: a novel molecular biomarker for nasopharyngeal carcinoma. Head Neck. 2016;38:E76–80. https://doi.org/10.1002/hed.24164.CrossRefPubMed

18.

Bennink RJ, van der Meulen FW, Freling NJ, Booij J. Somatostatin receptor scintigraphy in nasopharyngeal carcinoma. Clin Nucl Med. 2008;33:558–61. https://doi.org/10.1097/RLU.0b013e31817dec00.CrossRefPubMed

19.

Zhao L, Pang Y, Wang Y, Chen J, Zhuang Y, Zhang J, et al. Somatostatin receptor imaging with [⁶⁸Ga]GaDOTATATE Positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2022;49:1360–73. https://doi.org/10.1007/s00259-021-05587-7.CrossRefPubMed

20.

Lin Z, Zhu W, Zhang J, Miao W, Yao S, Huo L. Head-to-Head comparison of ⁶⁸Ga-NODAGA-JR11 and ⁶⁸Ga-DOTATATE PET/CT in patients with metastatic, well-differentiated neuroendocrine tumors: interim analysis of a prospective Bicenter Study. J Nucl Med. 2023;64:1406–11. https://doi.org/10.2967/jnumed.122.264890.CrossRefPubMed

21.

Puré E, Blomberg R. Pro-tumorigenic roles of fbroblast activation protein in cancer: back to the basics. Oncogene. 2018;37:4343–57. https://doi.org/10.1038/s41388-018-0275-3.CrossRefPubMedPubMedCentral

22.

Wu HB, Wang QS, Wang MF, Zhen X, Zhou WL, Li HS. Preliminary study of 11 C-choline PET/CT for T staging of locally advanced nasopharyngeal carcinoma: comparison with 18F-FDG PET/CT. J Nucl Med. 2011;52:341–6. https://doi.org/10.2967/jnumed.110.081190.CrossRefPubMed

23.

van den Brekel MW, Stel HV, Castelijns JA, Nauta JJ, van der Waal I, Valk J, et al. Cervical lymph node metastasis: assessment of radiologic criteria. Radiology. 1990;177:379–84. https://doi.org/10.1148/radiology.177.2.2217772.CrossRefPubMed

24.

Zhang GY, Liu LZ, Wei WH, Deng YM, Li YZ, Liu XW. Radiologic criteria of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma treated with radiation therapy. Radiology. 2010;255:605–12. https://doi.org/10.1148/radiol.10090289.CrossRefPubMed

25.

Grégoire V, Ang K, Budach W, Grau C, Hamoir M, Langendijk JA, et al. Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol. 2014;110:172–81. https://doi.org/10.1016/j.radonc.2013.10.010.CrossRefPubMed

26.

Henry LR, Lee HO, Lee JS, Klein-Szanto A, Watts P, Ross EA, et al. Clinical implications of fibroblast activation protein in patients with colon cancer. Clin Cancer Res. 2007;13:1736–41. https://doi.org/10.1158/1078-0432.CCR-06-1746.CrossRefPubMed

27.

Leibel SA, Fuks Z, Zelefsky MJ, Wolden SL, Rosenzweig KE, Alektiar KM, et al. Intensity-modulated radiotherapy. Cancer J. 2002;8:164–76. https://doi.org/10.1097/00130404-200203000-00010.CrossRefPubMed

28.

Lee AW, Ng WT, Pan JJ, Poh SS, Ahn YC, AlHussain H, et al. International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma. Radiother Oncol. 2018;126:25–36. https://doi:10.1016/j.radonc.2017.10.032.

29.

Li C, Yang Y, Hu F, Xu Y, Wu B, Huang J, et al. Evaluation of ¹¹C-Choline PET/CT for T Staging and Tumor Volume Delineation in Nasopharyngeal Cancer Patients in Comparison to ¹⁸F-FDG PET/CT. Clin Nucl Med. 2023;48:563 − 73. https://doi:10.1097/RLU.0000000000004645.

30.

Zaidi H, El Naqa I. PET-guided delineation of radiation therapy treatmentvolumes: a survey of image segmentation techniques. Eur J Nucl Med Mol Imaging. 2010;37:2165-87. https://doi:10.1007/s00259-010-1423-3.

31.

Yang SS, Wu YS, Chen WC, Zhang J, Xiao SM, Zhang BY, et al. Benefit of [¹⁸F]-FDG PET/CT for treatment-naïve nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2022;49:980 − 91. https://doi:10.1007/s00259-021-05540-8.

32.

Qin C, Song Y, Liu X, Gai Y, Liu Q, Ruan W, et al. Increased uptake of ⁶⁸Ga-DOTA-FAPI-04 in bones and joints: metastases and beyond. Eur J Nucl Med Mol Imaging. 2022;49:709 − 20. https://doi:10.1007/s00259-021-05472-3.

33.

Tang W, Wang Q, Yang S, Chen Y. Elevated 68Ga-FAPI activity in the Plasmacytoma of the ribs. Clin Nucl Med. 2021;46:523–4. https://doi.org/10.1097/RLU.0000000000003632.CrossRefPubMed

34.

Tang W, Wang Q, Yang S, Chen Y. 68Ga-FAPI outperforms 18F-FDG PET/CT in identifying bone metastasis and peritoneal carcinomatosis in a patient with metastatic breast cancer. Clin Nucl Med. 2020;45:913–5. https://doi.org/10.1097/RLU.0000000000003263.CrossRef

35.

Sun XS, Liu LT, Liu SL, Guo SS, Wen YF, Xie HJ, et al. Identifying optimal candidates for local treatment of the primary tumor among patients with de novo metastatic nasopharyngeal carcinoma: a retrospective cohort study based on EpsteinBarr virus DNA level and tumor response to palliative chemotherapy. BMC Cancer. 2019;19:92. https://doi.org/10.1186/s12885-019-5281-5.CrossRefPubMedPubMedCentral

36.

Zou X, You R, Liu H, He YX, Xie GF, Xie ZH, et al. Establishment and validation of M1 stage subdivisions for de novo metastatic nasopharyngeal carcinoma to better predict prognosis and guide treatment. Eur J Cancer. 2017;77:117–26. https://doi.org/10.1016/j.ejca.2017.02.029.CrossRefPubMed

37.

Meng K, Tey J, Ho FCH, Asim H, Cheo T. Utility of magnetic resonance imaging in determining treatment response and local recurrence in nasopharyngeal carcinoma treated curatively. BMC Cancer. 2020;20:193. https://doi.org/10.1186/s12885-020-6664-3.CrossRefPubMedPubMedCentral

38.

Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM. Radiation-induced fibrosis: mechanisms and implications for therapy. J Cancer Res Clin Oncol. 2015;141:1985–94. https://doi.org/10.1007/s00432-015-1974-6.CrossRefPubMedPubMedCentral

39.

Zhu W, Zhang J, Singh A, Kulkarni HR, Baum RP. Metastatic nasopharyngeal carcinoma treated with intraarterial combined with intravenous peptide receptor radionuclide therapy. Clin Nucl Med. 2019;44:989–90. https://doi.org/10.1097/RLU.0000000000002788.CrossRefPubMed

40.

Fu K, Pang Y, Zhao L, Lin L, Wu H, Sun L, et al. FAP-targeted radionuclide therapy with [¹⁷⁷Lu]Lu-FAPI-46 in metastatic nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2022;49:1767–9. https://doi.org/10.1007/s00259-021-05634-3.CrossRefPubMed

Titel: A head-to-head comparison of [68Ga]Ga-DOTATATE and [68Ga]Ga-FAPI PET/CT in patients with nasopharyngeal carcinoma: a single-center, prospective study
verfasst von: Jieling Zheng
Guochang Wang
Qian Ru
Yun Yang
Li Su
Wenlong Lv
Chunlin Ke
Peirong Wang
Xiaohui Liu
Li Zhang
Feng Liu
Weibing Miao
Publikationsdatum: 10.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-024-06744-4

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

A head-to-head comparison of [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT in patients with nasopharyngeal carcinoma: a single-center, prospective study

Abstract

Purpose

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten