Hybrid imaging detects results missed by CT in patients with deadly pancreatic cancer

Adding molecular imaging to the workup of patients with pancreatic cancer improves staging and enhances disease management, according to a study shared in the June issue of the Journal of Nuclear Medicine.

Pancreatic ductal adenocarcinomas (PDACs) are highly lethal, with only 10% of patients surviving five years after their diagnosis. Accurately staging the cancer is paramount for selecting treatment, and follow-up imaging is also key to earlier spotting metastatic spread.

Contrast-enhanced CT is the current gold standard for assessing this form of cancer, leaving PET scanning as merely an afterthought, the authors noted. But in their recent study, adding the PET/CT radiotracer 68Ga-FAPI proved beneficial.

“We know that PDAC is composed of certain fibroblasts that express fibroblast activation protein, which can be imaged with the novel PET radiotracer 68Ga-FAPI,” Manuel Röhrich, MD, a nuclear medicine physician at Heidelberg University Hospital in Germany, explained Monday. “Given this characteristic, we sought to explore the utility of 68Ga-FAPI PET/CT to image PDAC patients.”

They analyzed 19 PDAC patients who underwent contrast-enhanced CT followed by 68Ga-FAPI PET/CT imaging. Scan results differed in 10 of the 19 participants, leading to changes in disease staging.

Of those 12 with recurrent cancer, eight were upstaged, one downstaged and three remained the same. And among seven newly diagnosed patients, one was upstaged, with the other six diagnoses unchanged.

Given the results, Röhrich et al. believe molecular imaging with the novel imaging tracer may open up new avenues in managing pancreatic ductal adenocarcinomas.

“This analysis suggests that 68Ga-FAPI PET/CT is a promising new imaging modality in staging of PDAC that may help to detect new or clarify inconclusive results obtained by standard CT imaging,” Röhrich added. “Improvement in survival can only be achieved by effective treatment approaches customized to the individual patient’s disease status.”

The entire study is available here.

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