Head-to-head Evaluation of [F]FDG PET/CT and [Ga]Ga-HX01 PET/MR in Sarcoma Patients

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2025 Feb 20

PMID 39976700

Authors

Xiao Zhang

Yongkang Gai

Ting Ye

Li Fan

Linfeng Xiu

Weiwei Ruan

Fan Hu

Jing Chen

Xiaoli Lan

Affiliations

Soon will be listed here.

Abstract

Purpose: Tumor-associated neovasculature and energy metabolism reprogramming serve as critical indicators of tumor proliferation, progression, invasion, and metastasis. This study conducted a head-to-head clinical investigation and comparison of [F]FDG and [Ga]Ga-HX01 PET by reflecting neovasculature and glucose metabolism in sarcoma patients, respectively.

Methods: We reviewed the imaging data of sarcoma patients who underwent [Ga]Ga-HX01 PET/MR and [F]FDG PET/CT from June 29, 2022, to December 21, 2023. The two imaging modalities were performed on two separate days within one week of each other. A cohort of 21 patients with an average age of 45.81 ± 19.99 years were enrolled. The location, number and PET characteristics of all lesions were collected. The relationships between the two tracers were evaluated.

Results: Among the 21 patients, 4 underwent imaging for initial disease staging, while the remaining 17 were imaged to detect recurrences. Patient-based analysis revealed that [Ga]Ga-HX01 PET/MR diagnostic performance was equivalent to [F]FDG PET/CT in lesion detection (P = 1.0). The SUVmax value of [Ga]Ga-HX01 (4.64 ± 1.90) was significantly lower than that of [F]FDG (9.43 ± 6.17, P = 0.002) across all patients. In terms of lesion-based analysis, [Ga]Ga-HX01 identified two additional lesions compared to [F]FDG, though this difference was not statistically significant (94 vs. 92, P = 0.678). The SUVmax value for all lesions with [Ga]Ga-HX01 (3.47 ± 1.68) was also lower than that with [F]FDG (5.82 ± 4.81, P = 0.003). Notably, [Ga]Ga-HX01 was preferred in patients receiving hematopoietic cytokines.

Conclusion: [Ga]Ga-HX01 PET offers comparable diagnostic efficacy to [F]FDG PET/CT in sarcoma, with potential advantages in specific clinical scenarios. Larger cohorts are needed to validate these findings.

Clinical Trial Registration: NCT05490849 and NCT06416774.

References

van der Graaf W, Tesselaar M, McVeigh T, Oyen W, Frohling S . Biology-guided precision medicine in rare cancers: Lessons from sarcomas and neuroendocrine tumours. Semin Cancer Biol. 2022; 84:228-241. DOI: 10.1016/j.semcancer.2022.05.011. View

Wallander K, Ofverholm I, Boye K, Tsagkozis P, Papakonstantinou A, Lin Y . Sarcoma care in the era of precision medicine. J Intern Med. 2023; 294(6):690-707. DOI: 10.1111/joim.13717. View

Weiss A, Harrison D . Soft Tissue Sarcomas in Adolescents and Young Adults. J Clin Oncol. 2023; 42(6):675-685. DOI: 10.1200/JCO.23.01275. View

Liu Z, Chen H, Zheng L, Sun L, Shi L . Angiogenic signaling pathways and anti-angiogenic therapy for cancer. Signal Transduct Target Ther. 2023; 8(1):198. PMC: 10175505. DOI: 10.1038/s41392-023-01460-1. View

Ye L, Jiang Y, Zhang M . Crosstalk between glucose metabolism, lactate production and immune response modulation. Cytokine Growth Factor Rev. 2022; 68:81-92. DOI: 10.1016/j.cytogfr.2022.11.001. View

Abdel-Wahab A, Mahmoud W, Al-Harizy R . Targeting glucose metabolism to suppress cancer progression: prospective of anti-glycolytic cancer therapy. Pharmacol Res. 2019; 150:104511. DOI: 10.1016/j.phrs.2019.104511. View

Hanahan D . Hallmarks of Cancer: New Dimensions. Cancer Discov. 2022; 12(1):31-46. DOI: 10.1158/2159-8290.CD-21-1059. View

Liu Y, Huang N, Liao S, Rothzerg E, Yao F, Li Y . Current research progress in targeted anti-angiogenesis therapy for osteosarcoma. Cell Prolif. 2021; 54(9):e13102. PMC: 8450128. DOI: 10.1111/cpr.13102. View

Yang Q, Chen T, Wang S, Zhang X, Yao Z . Apatinib as targeted therapy for advanced bone and soft tissue sarcoma: a dilemma of reversing multidrug resistance while suffering drug resistance itself. Angiogenesis. 2020; 23(3):279-298. DOI: 10.1007/s10456-020-09716-y. View

10.

Tang M, Jiang S, Huang X, Ji C, Gu Y, Qi Y . Integration of 3D bioprinting and multi-algorithm machine learning identified glioma susceptibilities and microenvironment characteristics. Cell Discov. 2024; 10(1):39. PMC: 11003988. DOI: 10.1038/s41421-024-00650-7. View

11.

Rebelos E, Mari A, Oikonen V, Iida H, Nuutila P, Ferrannini E . Evaluation of renal glucose uptake with [F]FDG-PET: Methodological advancements and metabolic outcomes. Metabolism. 2022; 141:155382. DOI: 10.1016/j.metabol.2022.155382. View

12.

Wang L, Rajah A, Brown C, McCaffrey L . CD13 orients the apical-basal polarity axis necessary for lumen formation. Nat Commun. 2021; 12(1):4697. PMC: 8338993. DOI: 10.1038/s41467-021-24993-x. View

13.

Zang J, Wen X, Lin R, Zeng X, Wang C, Shi M . Synthesis, preclinical evaluation and radiation dosimetry of a dual targeting PET tracer [Ga]Ga-FAPI-RGD. Theranostics. 2022; 12(16):7180-7190. PMC: 9576616. DOI: 10.7150/thno.79144. View

14.

Bose D, Roy L, Chatterjee S . Peptide therapeutics in the management of metastatic cancers. RSC Adv. 2022; 12(33):21353-21373. PMC: 9345020. DOI: 10.1039/d2ra02062a. View

15.

Wan Z, Zhang F, Wang K, Liu Y, Huang Z . Isolated Lymph Node Metastasis as Initial Presentation of Collecting Duct Carcinoma on 68Ga-Pentixafor PET/CT. Clin Nucl Med. 2025; . DOI: 10.1097/RLU.0000000000005663. View

16.

Zhang Y, Qiu Y, Karimi A, Smith B . Systematic review: Mechanisms of photoactive nanocarriers for imaging and therapy including controlled drug delivery. Eur J Nucl Med Mol Imaging. 2024; 52(4):1576-1595. PMC: 11849580. DOI: 10.1007/s00259-024-07014-z. View

17.

Toriihara A, Duan H, Thompson H, Park S, Hatami N, Baratto L . F-FPPRGD PET/CT in patients with metastatic renal cell cancer. Eur J Nucl Med Mol Imaging. 2019; 46(7):1518-1523. DOI: 10.1007/s00259-019-04295-7. View

18.

Wu J, Tian J, Zhang Y, Ji H, Sun J, Wang X . F-Alfatide II for the evaluation of axillary lymph nodes in breast cancer patients: comparison with F-FDG. Eur J Nucl Med Mol Imaging. 2022; 49(8):2869-2876. DOI: 10.1007/s00259-021-05333-z. View

19.

Wu J, Wang S, Zhang X, Teng Z, Wang J, Yung B . F-Alfatide II PET/CT for Identification of Breast Cancer: A Preliminary Clinical Study. J Nucl Med. 2018; 59(12):1809-1816. PMC: 6910641. DOI: 10.2967/jnumed.118.208637. View

20.

Zhang X, Kang F, Zheng H, Gai Y, Wang J, Lan X . Melanin-targeted [F]-PFPN PET imaging may shed light for clear cell sarcoma. Eur J Nucl Med Mol Imaging. 2023; 51(1):196-201. DOI: 10.1007/s00259-023-06439-2. View