FAPI-PET/CT guided radiotherapy for patients with esophageal cancer

Abstract Background Cancer associated fibroblasts have become a target of interest in different malignancies for positron emission tomography (PET) imaging, using positron emitter labelled fibroblast activation protein inhibitors (FAPI). New data underline the advanced imaging properties of FAPI-PET...

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Main Authors: Kai Kröger, Niklas Benedikt Pepper, David Ventura, Fabian M. Troschel, Philipp Backhaus, Kambiz Rahbar, Bernhard Glasbrenner, Matthias Brüwer, Andreas Pascher, Michael Schäfers, Hans Theodor Eich, Wolfgang Roll
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02606-x
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Summary:Abstract Background Cancer associated fibroblasts have become a target of interest in different malignancies for positron emission tomography (PET) imaging, using positron emitter labelled fibroblast activation protein inhibitors (FAPI). New data underline the advanced imaging properties of FAPI-PET/CT for the staging of esophageal cancer compared to standard imaging. Potential benefits of FAPI-PET/CT in radiation therapy planning are the subject of this investigation. Methods Ten patients with newly diagnosed esophageal cancer treated with radiochemotherapy (RCT) were retrospectively analyzed. All patients underwent [68Ga]OncoFAP-PET/CT in treatment position to facilitate radiation treatment planning. Six patients received neoadjuvant RCT as part of a trimodal therapy and four patients underwent definitive RCT. In five cases, restaging after initial treatment was performed with FAPI-PET/CT. Results [68Ga]OncoFAP-PET/CT based imaging showed a high correlation with the endoscopic staging for initial imaging. In three cases, new sites of disease were unmasked, not visible in CT- and endosonographic staging. [68Ga]OncoFAP-PET/CT based RT delineation offered good definition of clinical target volumes, especially in retro-/paracardial areas and the gastroesophageal junction. Conclusion [68Ga]OncoFAP-PET/CT may aid and improve radiation treatment planning for patients with esophageal cancer.
ISSN:1748-717X