| خلاصه مقاله | Aim/Introduction: Cancer-associated fibroblasts (CAFs) express high levels of fibroblast activation protein (FAP). A variety of cancers with desmoplastic reactions, such as breast cancer, can be imaged with SPECT imaging with FAP inhibitors (FAPIs) since FAP is almost absent from healthy tissue. This study evaluated 99mTc-labeled FAP inhibitor radioligand ([99mTc] Tc-FAPI) for tumor stroma imaging in patients with various cancers and analyzed results from the perspective of stromal heterogeneity.
Materials and Methods: Twenty patients with confirmed breast, lung, and colorectal cancers were included in this study. The patients had previously undergone other scans to evaluate the disease. SPECT imaging was performed one hour after [99mTc] Tc-FAPI injection. Lesions were categorized into three types: primary tumors, lymph node metastases, and distant metastases (Dm). Tumor-to-background ratios (T/B) were used to calculate semi-quantitative lesion uptake analysis. In all cases, histopathology corroborated the oncological diagnosis.
Results: [99mTc] Tc-FAPI detected primary tumors, with 100% and 94% sensitivity and specificity, respectively. Moreover, Tc-FAPI demonstrated lymph nodes and distant metastases with high accuracy due to lower background activity and higher uptake in sub-centimetric lesions. Compared to lymph nodes and distant metastases, [99mTc] Tc-FAPI uptake was greater in primary tumors in the T/B data. Interestingly, [99mTc] Tc-FAPI was well absorbed in peritoneal carcinomatosis lesions in recurrent colorectal cancer.
Conclusion: [99mTc] Tc-FAPI SPECT imaging can provid valuable information about the microenvironment surrounding tumors and is considered a promising tool in the prognostic assessment of tumors, particularly breast cancer and recurrent colorectal cancers. |