Prognostic value of fibroblast activation protein expressing tumor volume calculated from [68 Ga]Ga-FAPI PET/CT in patients with esophageal squamous cell carcinoma

• Published in: European journal of nuclear medicine and molecular imaging 2023, Vol.50 (2), p.593-601
• Main Authors: Zhao, Liang, Pang, Yizhen, Chen, Shanyu, Chen, Jianhao, Li, Yimin, Yu, Yifeng, Huang, Chunbin, Sun, Long, Wu, Hua, Chen, Haojun, Lin, Qin
• Format: Article
• Language: English
• Subjects: Cardiology; Chemoradiotherapy; Chemotherapy; Computed tomography; Confidence intervals; Esophageal cancer; Esophageal Neoplasms - diagnostic imaging; Esophageal Neoplasms - therapy; Esophageal Squamous Cell Carcinoma - diagnostic imaging; Esophageal Squamous Cell Carcinoma - therapy; Fibroblast activation protein; Fibroblasts; Fibroblasts - metabolism; Fluorodeoxyglucose F18 - metabolism; Gallium Radioisotopes; Humans; Imaging; Mathematical analysis; Medical prognosis; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Oncology – Digestive tract; Original Article; Orthopedics; Parameters; Pilot Projects; Positron emission; Positron Emission Tomography Computed Tomography - methods; Prognosis; Prospective Studies; Proteins; Radiation therapy; Radiology; Rank tests; Regression analysis; Retrospective Studies; Squamous cell carcinoma; Statistical analysis; Steering; Survival; Tumor Burden; Tumors
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-022-05989-1

Background This study aimed to investigate the prognostic value of semiquantitative parameters derived from [ 68  Ga]Ga-fibroblast activation protein inhibitor (FAPI) PET/CT for patients with esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy. Methods We conducted a retrospective analysis on patients from a prospective parent study (NCT04416165). A total of 45 patients with locally advanced ESCC who underwent [ 68  Ga]Ga-FAPI from December 2019 to March 2021 were included. The maximum standard uptake value (SUVmax), gross tumor volume (GTV), and total lesion-FAPI (TL-FAPI) of the primary tumor were calculated from the corresponding PET/CT image. Unpaired parameters were compared using Student’s t test or the Mann–Whitney U test. Paired parameters were compared using the paired t test or the Wilcoxon matched-pairs signed-rank test. Kaplan–Meier curves were generated to calculate progression-free survival (PFS) and overall survival (OS) rates, and Cox regression analysis was performed to determine which PET/CT parameters were prognostic factors for PFS and/or OS. Results Thirty-four of the 45 patients met the criteria, and the median follow-up time was 24 months (16–29 months). SUVmax-FAPI, GTV FAPI , and TL-FAPI in patients with stage T4 tumors were significantly higher than those in patients with stage T2/T3 tumors (all P