FAPI PET improves staging and clinical management for a significant portion of pancreatic cancers
FAPI PET imaging may provide more accurate insight into the spread of pancreatic cancer than more commonly used 18F-FDG PET/CT, potentially improving disease management plans and patient outcomes.
That’s according to a new meta-analysis published in Academic Radiology detailing a side-by-side comparison between the two imaging methods. After examining the cases of more than 300 patients, researchers determined that fibroblast activating protein inhibitor (FAPI) radiotracers have greater sensitivity for identifying primary pancreatic tumors, lymph node metastases and distant metastases. What’s more, FAPI PET also provides more accurate TNM staging, authors of the new study indicated.
“Pancreatic tumors are characterized by a strong stromal desmoplastic reactions around cancer cells, and cancer-associated fibroblasts (CAFs) are the main effector cells in the desmoplastic reaction, and FAP expressed on CAFs,” corresponding author Jiong Cai, with the Department of Nuclear Medicine at the Affiliated Hospital of Zunyi Medical University in China, and colleagues explained. “Therefore, FAP is an important potential target for the diagnosis and treatment of pancreatic tumors.”
Experts analyzed seven original studies that compared the use of FAPI PET and 18F-FDG PET/CT for the diagnosis and staging of pancreatic cancer. Combining the findings from those studies, the team found that FAPI PET had a significantly higher pooled sensitivity, at 0.99 compared to 0.84, and also yields higher AUC, at 0.99 versus 0.91, respectively.
In addition to its improved sensitivity to primary tumors, lymph node metastases and distant node metastases, FAPI PET also improved staging for 25% of the cases in the analysis, resulting in a change in treatment for 11.7% of patients.
The group explained that these findings could be attributed to the high uptake of 68Ga/18F-FAPI in primary pancreatic tumors and the low background activity of normal pancreas. Their findings provide further insight into the benefits of FAPI imaging for providers tasked with managing patients’ pancreatic cancer and suggested that the method “may replace the application of 18F-FDG in PC in the future.”
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.