Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer

Abstract Purpose To evaluate the added value of additional 68Ga-FAPI PET/CT following CT for primary staging, detection of postoperative recurrence, and management of gastric cancer patients. Methods We retrospectively included patients with gastric cancers who underwent contrast-enhanced computed t...

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Main Authors: Shunyu Zhang, Minggang Su, Qianrui Li, Qiancheng Hu, Xijiao Liu, Xiaolong Chen, Hongfeng Gou
Format: Article
Language:English
Published: Springer 2025-01-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-024-06075-9
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author Shunyu Zhang
Minggang Su
Qianrui Li
Qiancheng Hu
Xijiao Liu
Xiaolong Chen
Hongfeng Gou
author_facet Shunyu Zhang
Minggang Su
Qianrui Li
Qiancheng Hu
Xijiao Liu
Xiaolong Chen
Hongfeng Gou
author_sort Shunyu Zhang
collection DOAJ
description Abstract Purpose To evaluate the added value of additional 68Ga-FAPI PET/CT following CT for primary staging, detection of postoperative recurrence, and management of gastric cancer patients. Methods We retrospectively included patients with gastric cancers who underwent contrast-enhanced computed tomography (ceCT), followed by 68Ga-FAPI PET/CT within 30 days. 68Ga-FAPI PET/CT was performed for initial staging or detection of postoperative recurrence. Two nuclear medicine physicians and a radiologist independently decided on imaging-based staging. Pre-68Ga-FAPI PET/CT treatment decisions were made by a simulated tumor board and post-68Ga-FAPI PET/CT decisions were extracted from medical records. We evaluated the impact of 68Ga-FAPI PET/CT with inconsistent new findings based on the initial findings from ceCT and the resulting changes in treatment strategies. Results We included 112 patients, 84 for initial staging and 28 for detection of postoperative recurrence. Compared to CT, 29 new findings in 24 patients were diagnosed as, or ruled out, cancer involvement on 68Ga-FAPI PET/CT. Among the 112 patients, 21 patients (18.8%) experienced changes in stage or postoperative recurrence. Among patients for initial staging, 14 had stage changes, with 10 being upstaged and 4 being downstaged. Among patients for detection of postoperative recurrence, 7 more patients were diagnosed with tumor recurrence. New findings of 68Ga-FAPI PET/CT led to treatment change in 20/112 (17.9%) patients, which was deemed of major change in 19 patients and minor change in 1 patient. Conclusions 68Ga-FAPI PET/CT is valuable for precise staging and detection of postoperative recurrence of gastric cancers, and has the potential to influence management.
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spelling doaj-art-280f445da6314ec3b988e93e80f8f02b2025-02-09T12:10:28ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-01-01151111110.1007/s00432-024-06075-9Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancerShunyu Zhang0Minggang Su1Qianrui Li2Qiancheng Hu3Xijiao Liu4Xiaolong Chen5Hongfeng Gou6Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of Nuclear Medicine, West China Hospital, Sichuan UniversityDepartment of Nuclear Medicine, West China Hospital, Sichuan UniversityDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityGastric Cancer Center, West China Hospital, Sichuan UniversityDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityAbstract Purpose To evaluate the added value of additional 68Ga-FAPI PET/CT following CT for primary staging, detection of postoperative recurrence, and management of gastric cancer patients. Methods We retrospectively included patients with gastric cancers who underwent contrast-enhanced computed tomography (ceCT), followed by 68Ga-FAPI PET/CT within 30 days. 68Ga-FAPI PET/CT was performed for initial staging or detection of postoperative recurrence. Two nuclear medicine physicians and a radiologist independently decided on imaging-based staging. Pre-68Ga-FAPI PET/CT treatment decisions were made by a simulated tumor board and post-68Ga-FAPI PET/CT decisions were extracted from medical records. We evaluated the impact of 68Ga-FAPI PET/CT with inconsistent new findings based on the initial findings from ceCT and the resulting changes in treatment strategies. Results We included 112 patients, 84 for initial staging and 28 for detection of postoperative recurrence. Compared to CT, 29 new findings in 24 patients were diagnosed as, or ruled out, cancer involvement on 68Ga-FAPI PET/CT. Among the 112 patients, 21 patients (18.8%) experienced changes in stage or postoperative recurrence. Among patients for initial staging, 14 had stage changes, with 10 being upstaged and 4 being downstaged. Among patients for detection of postoperative recurrence, 7 more patients were diagnosed with tumor recurrence. New findings of 68Ga-FAPI PET/CT led to treatment change in 20/112 (17.9%) patients, which was deemed of major change in 19 patients and minor change in 1 patient. Conclusions 68Ga-FAPI PET/CT is valuable for precise staging and detection of postoperative recurrence of gastric cancers, and has the potential to influence management.https://doi.org/10.1007/s00432-024-06075-968Ga-FAPI PET/CTGastric cancerStagingRestagingTherapeutic management
spellingShingle Shunyu Zhang
Minggang Su
Qianrui Li
Qiancheng Hu
Xijiao Liu
Xiaolong Chen
Hongfeng Gou
Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
Journal of Cancer Research and Clinical Oncology
68Ga-FAPI PET/CT
Gastric cancer
Staging
Restaging
Therapeutic management
title Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
title_full Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
title_fullStr Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
title_full_unstemmed Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
title_short Impact of 68Ga-FAPI positron emission tomography/computed tomography on staging and tumor management in patients with gastric cancer
title_sort impact of 68ga fapi positron emission tomography computed tomography on staging and tumor management in patients with gastric cancer
topic 68Ga-FAPI PET/CT
Gastric cancer
Staging
Restaging
Therapeutic management
url https://doi.org/10.1007/s00432-024-06075-9
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