[Ga]FAPI-PET/CT for Radiation Therapy Planning in Biliary Tract, Pancreatic Ductal Adeno-, and Adenoidcystic Carcinomas

Overview

Journal Sci Rep

Specialty Science

Date 2022 Sep 28

PMID 36171444

Authors

Nika Guberina

Lukas Kessler

Christoph Pottgen

Maja Guberina

Martin Metzenmacher

Ken Herrmann

Maja Mucha

Christoph Rischpler

Frank Indenkampen

Jens T Siveke

Jurgen Treckmann

Lale Umutlu

Stefan Kasper

Wolfgang P Fendler

Martin Stuschke

Affiliations

Soon will be listed here.

Abstract

Biliary-tract-carcinomas (BTC), pancreatic-ductal-adenocarcinomas (PDAC) and adenoidcystic-carcinomas (AC) have in common that they are traditionally treated with large clinical-target-volumes (CTV). The aim of this study is to examine the impact of pretreatment-[Ga]FAPI-PET/CT on target-volume-definition and posttreatment-[Ga]FAPI-PET/CT-response-assessment for BTC-, PDAC- and AC-patients referred to radiation-therapy. All consecutive BTC-, PDAC-, and AC-patients who received pretreatment-[Ga]FAPI-PET/CT±[F]FDG-PET/CT were included from 01.01.2020 to 01.03.2022. MTV and SUV were separately generated based on [Ga]FAPI- and [F]FDG-PET/CT-images. A [Ga]FAPI- and [F]FDG-based-CTV was defined. Treatment-plans were compared. Treatment-response was reassessed by a second [Ga]FAPI-PET/CT and [F]FDG-PET/CT after treatment-completion. Intermodality comparison of lesion-to-background-ratios [SUV/SUV] for individual timepoints t and t revealed significant higher values for [Ga]FAPI compared to [F]FDG (t, p = 0.008; t, p = 0.005). Intermodality comparison of radiation-therapy-plans showed that [Ga]FAPI-based planning resulted in D100% = 97.2% and V95% = 98.8% for the [F]FDG-MTV. [F]FDG-based-planning resulted in D100% = 35.9% and V95% = 78.1% for [Ga]FAPI-MTV. [F]FDG-based-planning resulted only in 2 patients in V95% > 95% for [Ga]FAPI-MTV, and in 1 patient in D100% > 97% for [Ga]FAPI-MTV. GTV-coverage in terms of V95% was 76.4% by [F]FDG-based-planning and 99.5% by [Ga]FAPI-based-planning. Pretreatment [Ga]FAPI-PET/CT enhances radiation-treatment-planning in this particular group of patients. While perilesional and tumoral follow-up [F]FDG-uptake behaved uniformly, perilesional and tumoral reaction may differ in follow-up [Ga]FAPI-imaging. Complementary [Ga]FAPI- and [F]FDG-imaging enhance treatment-response-assessment.

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