E3284. <sup>99m</sup>Tc-FAPI SPECT in the Evaluation of Lung Cancer: Comparison with <sup>99m</sup>Tc (V) – DMSA SPECT
Authors
Esmaeil Gharepapagh;
Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, ; Department of Nuclear Medicine, Medical School, Tabriz University of Medical Sciences,
Sahar Rezaei;
Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, ; Department of Nuclear Medicine, Medical School, Tabriz University of Medical Sciences,
Objective:
In recent years, efforts have been made to develop a more precise and specific radioactive tracer to detect and evaluate various types of cancer, including lung cancer. Increasing tumor microenvironment fibroblast overexpression of fibroblast activation protein (FAP) has led to the introduction of <sup>99m</sup>Tc -FAPI radioligand, a newly developed tumor-seeking agent capable of detecting various types of cancer. This research aimed to compare the diagnostic efficacy of <sup>99m</sup>Tc -FAPI and <sup>99m</sup>Tc (V-DMSA whole body/SPECT imaging in the same subjects with a solitary pulmonary lesion.
Materials and Methods:
The study included 20 patients with lung cancer. In this line, histopathological confirmation was provided for an accurate cancer diagnosis. In all cases, a whole-body scan, as well as SPECT was performed 1–3 hours (average of 2 hours) after the IV administration of 740 ± 65.1 MBq for both radiotracers. A focal increase in uptake in the lungs was considered abnormal. We divided the total lesions into three categories: primary tumors (PT), lymph node metastases (LNm), and distant metastases (Dm). All patients underwent lung lesion biopsies and histopathological examinations. Finally, the scan results of both methods were compared with biopsy results.
Results:
It must be noted however that <sup>99m</sup>Tc-FAPI and 99mTc (V-DMSA detected 100% of PT, although the number of positive LNms and Dms was significantly higher with <sup>99m</sup>Tc-FAPI than with <sup>99m</sup>Tc (V-DMSA imaging. That is, <sup>99m</sup>Tc -FAPI SPECT detected PT (100%), LNm (91%), and Dm (87%) in contrast to 99mTc (V-DMSA, which detected PT (100%), LNm (61%), and Dm (52%).
Conclusion:
Based on the results of this pilot clinical research, <sup>99m</sup>Tc-FAPI SPECT imaging is an important tool in the prognostic assessment of lung cancer compared to <sup>99m</sup>Tc (V–DMSA scan.
