Increased Uptake of 68Ga-DOTA-IBA in Multiple Subcutaneous Metastases of Prostate Cancer.

ABSTRACT: Subcutaneous metastases are rare in prostate cancer. Herein, we present a case of a 66-year-old man with prostate cancer, who underwent 68Ga-labeled DOTA-ibandronic acid (68Ga-DOTA-IBA) PET/CT to explore the possibility of 177Lu-DOTA-IBA treatment. 68Ga-DOTA-IBA PET/CT demonstrated intensely increased uptake in the multiple osteoblastic bone metastases. Unexpectedly, 68Ga-DOTA-IBA uptake in multiple subcutaneous metastases was also noted.

68 Ga-FAPI Response Evaluation Pitfall in a Patient With Esophageal Cancer After Neoadjuvant Therapy.

ABSTRACT: We report the 68 Ga-FAPI PET/CT findings of inflammatory changes and fibrosis in a 55-year-old woman with a history of esophageal cancer after neoadjuvant therapy, which needs to be differentiated from other esophageal diseases during evaluation.

68Ga-DOTA-IBA PET/CT and 18F-FDG PET/CT in Ewing Sarcoma.

ABSTRACT: A 29-year-old man with Ewing sarcoma in the right ankle underwent 68Ga-DOTA-IBA PET/CT and 18F-FDG PET/CT, both of which showed high radiotracer activity for the primary tumor. Interestingly, bone metastases were detected early using 68Ga-DOTA-IBA PET/CT for the sixth thoracic vertebrae and with 18F-FDG PET/CT for the bilateral humerus. Higher uptake of 68Ga-DOTA-IBA was found in both primary and metastatic sites of Ewing sarcoma. 177Lu-DOTA-IBA may be one of the possible therapies for metastatic or recurrent Ewing sarcoma.

Incidental Uptake of 68Ga-DOTA-IBA in Prostate Adenocarcinoma.

ABSTRACT: 68Ga-labeled DOTA-ibandronic acid (68Ga-DOTA-IBA) is a novel PET agent developed for bone tumors. In addition, 68Ga-DOTA-IBA uptake in nonosseous findings has also been reported. Herein, we present a case of 68Ga-DOTA-IBA uptake in primary prostate adenocarcinoma.

Prospective comparison of 68Ga-DOTA-ibandronate and bone scans for detecting bone metastases in breast cancer.

Introduction: 68Ga labeled DOTA-Ibandronate (68Ga-DOTA-IBA) positron emission tomography/computed tomography (PET/CT), is a novel bone-targeting imaging tracer and promising diagnostic method for bone metastases detection. Therefore, this study aimed to compare 68Ga-DOTA-IBA PET/CT to the 99mTc-MDP whole-body bone scan (WBBS) for detecting bone metastases in breast cancer (BC). Materials and methods: In this prospective study, 45 women with BC underwent imaging via 68Ga-DOTA-IBA PET/CT and 99mTc-MDP WBBS. Clinical and demographic information as well as BC imaging features were recorded. The two methods were compared in terms of their detection rate for bone metastases and the number of lesions. Results: The 45 women were aged 53.5 ± 11.0 years. The bone metastases detection rate with 68Ga-DOTA-IBA PET/CT was 100% (45/45) and with 99mTc-MDP WBBS was 95.6% (43/45). A total of 546 bone metastases lesions were detected. The lesion detection rate using 68Ga-DOTA-IBA PET/CT was 100% (546/546) and using 99mTc-MDP WBBS was 67.8% (370/546). More lesions were found at each site via 68Ga-DOTA-IBA than via 99mTc-MDP WBBS. Conclusions: 68Ga-DOTA-IBA PET/CT is a more sensitive method than 99mTc-MDP WBBS for assessing bone metastases in BC and may therefore represent a useful imaging technique for bone metastases, while offering a visual basis for 177Lu-DOTA-IBA diagnosis and therapy response assessments for BC. Further validation using a broader study cohort is warranted to confirm these findings. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=170163, identifier ChiCTR2200064487.

Metastatic Lung Adenocarcinoma Received Combined 177 Lu-FAP-2286 Radiation Therapy and Targeted Therapy.

ABSTRACT: A 56-year-old man with metastatic lung adenocarcinoma received combined 177 Lu-FAP-2286 radiation therapy and targeted therapy. After 1 treatment cycle, improvement of symptoms and radiological remission was observed. Moreover, the patient did not report any adverse effects.

68 Ga-DOTA-IBA Uptake in Breast cancer.

ABSTRACT: A 77-year-old woman with recently diagnosed breast cancer underwent 68 Ga-labeled DOTA-ibandronic acid ( 68 Ga-DOTA-IBA) PET/CT scan for the evaluation of bone metastases. The examination revealed increased tracer uptake, indicating that the cervical vertebrae presented osteoblastic metastasis. Interestingly, the breast cancer also showed enhanced activity of 68 Ga-DOTA-IBA.

177 Lu-FAP-2286 Therapy in a Metastatic Bone Malignant Solitary Fibrous Tumor.

ABSTRACT: A 57-year-old woman with a metastatic bone malignant solitary fibrous tumor received 177 Lu-FAP-2286 therapy. After 1 treatment cycle, 68 Ga-FAP-2286 PET/CT revealed remission of the lesions. Moreover, the patient did not report any adverse effects.

Elevated FAPI Activity in an Adult Brodie Abscess.

ABSTRACT: We report an adult Brodie abscess with elevated activity of 18 F-FDG and 68 Ga-FAPI (fibroblast activating protein inhibitor), mimicking bone metastasis. Our case illustrates that Brodie abscess should also be contemplated in the differential diagnosis of osteolytic lesions with increased 68 Ga-FAPI uptake.

A phase 1 trial to determine the maximum tolerated dose and patient-specific dosimetry of [177Lu]Lu-LNC1003 in patients with metastatic castration-resistant prostate cancer.

PURPOSE: This translational study aimed to determine the maximum tolerated dose (MTD), safety, dosimetry, and therapeutic efficacy of 177Lu-PSMA-EB-01 (denoted as [177Lu]Lu-LNC1003) in patients with metastatic castration-resistant prostate cancer (mCRPC). METHODS: A total of 13 patients with mCRPC were recruited in this study. A standard 3 + 3 dose escalation protocol was performed. The following dose levels were ultimately evaluated: 1.11, 1.85, and 2.59 GBq/cycle. Patients received [177Lu]Lu-LNC1003 therapy for up to two cycles at a 6-week interval. RESULTS: Patients received fractionated doses of [177Lu]Lu-LNC1003 ranging from 1.11 to 2.59 GBq per cycle. Myelosuppression was dose-limiting at 2.59 GBq, and 1.85 GBq was determined to be the MTD. The total-body effective dose for 177Lu-LNC1003 was 0.35 ± 0.05 mSv/MBq. The salivary glands were found to receive the highest estimated radiation dose, which was calculated to be 3.61 ± 2.83 mSv/MBq. The effective doses of kidneys and red bone marrow were 1.88 ± 0.35 and 0.22 ± 0.04 mSv/MBq, respectively. The tumor mean absorbed doses for bone and lymph node metastases were 8.52 and 9.51 mSv/MBq. Following the first treatment cycle, PSA decline was observed in 1 (33.3%), 4 (66.7%), and 2 (50.0%) patients at dose levels 1 (1.11 GBq), 2 (1.85 GBq), and 3 (2.59 GBq), respectively. Compared with the baseline serum PSA value, 1 (33.3%) at dose level 1 and 4 (66.6%) patients at dose level 2, presented a PSA decline after the second treatment cycle. CONCLUSION: This phase 1 trial revealed that the MTD of [177Lu]Lu-LNC1003 is 1.85 GBq. The treatment with multiple cycles at the dose of 1.11 GBq /cycle and 1.85 GBq /cycle was well tolerated. [177Lu]Lu-LNC1003 has higher tumor effective doses in bone and lymph nodes metastases while the absorbed dose in the red bone marrow should be closely monitored in future treatment studies with higher doses and multiple cycles. The frequency of administration also needs to be further explored to assess the efficacy and side effects of [177Lu]Lu-LNC1003 treatment. TRIAL REGISTRATION: 177Lu-PSMA-EB-01 in patients with metastatic castration-resistant prostate cancer (NCT05613738, Registered 14 November 2022). URL of registry https://classic. CLINICALTRIALS: gov/ct2/show/NCT05613738.

Elevated FAPI Activity in Ulcerative Fungal Esophagitis.

ABSTRACT: We report a case of ulcerative fungal esophagitis with elevated activity of 18 F-FDG and 68 Ga-FAPI (fibroblast-activating protein inhibitor). Our findings suggest that ulcerative fungal esophagitis should be considered in the differential diagnosis of cancer-like esophageal mass with increased 68 Ga-FAPI uptake.

Pulmonary Cryptococcosis: Intense Uptake on Both 18 F-FDG and 68 Ga-FAPI PET/CT.

ABSTRACT: A 57-year-old woman without hepatitis B or immunodeficiency presented with right upper abdominal pain and cough for 3 months. CT revealed one nodule in the lung and another in the liver. Both 18 F-FDG and 68 Ga-FAPI PET/CT showed increased tracer uptake in these 2 nodules, suggesting pulmonary carcinoma with hepatic metastasis. Finally, biopsies of these 2 nodules demonstrated the diagnoses of hepatic adenocarcinoma and pulmonary cryptococcosis. This case highlights that cryptococcosis can be FAPI-avid.

Unexpected Solitary Subcutaneous Metastasis From Esophageal Carcinoma Revealed by MDP Bone Scintigraphy.

ABSTRACT: A 60-year-old man with back pain underwent 99m Tc-MDP to evaluate bone metastases from newly esophageal carcinoma. No bone metastasis was found on the whole-body bone scan. Unexpectedly, subcutaneous metastasis revealed increased 99m Tc-MDP activity.

Early Detection of Gastric Intramucosal Adenocarcinoma on 68 Ga-FAPI PET/CT.

ABSTRACT: 18 F-FDG PET/CT may sometimes not be an ideal imaging method for gastric adenocarcinoma. Because of the unstable physiological uptake of 18 F-FDG in the gastrointestinal tract and muscles, it may interfere with the detection of lesions. We present a case of gastric intramucosal adenocarcinoma detected by 68 Ga-FAPI PET/CT in a patient with nasopharyngeal carcinoma.

Comparison of 18 F-FDG and 68 Ga-FAPI-04 Uptake in Postoperative Re-evaluation of Gastric, Duodenal, and Colorectal Cancers.

PURPOSE: To compare the potential efficacy of 68 Ga-FAPI-04 PET/CT with that of 18 F-FDG PET/CT for detecting tumor recurrence and nodal and distant metastases in gastric, duodenal, and colorectal cancers. METHODS: This single-center retrospective clinical study was performed at the Affiliated Hospital of Southwest Medical University between January 2020 and June 2022. Participants with gastric, duodenal, and colorectal cancers after curative resection underwent both 68 Ga-FAPI-04 and 18 F-FDG PET/CT. Histopathologic examination, morphologic imaging, and/or follow-up imaging served as the reference standards. The SUV max of the tumor recurrence and nodal and distant metastases between 18 F-FDG and 68 Ga-FAPI-04 PET/CT were compared using the paired-sample t test. RESULTS: Forty-one participants with gastric, duodenal, and colorectal cancers were enrolled in the study (median age, 51 years; range, 19-75 years). The sensitivity of 68 Ga-FAPI-04 PET/CT was higher than that of 18 F-FDG PET/CT for detecting tumor recurrence (6 of 6 [100%] vs 4 of 6 [67%]), nodal metastases (92 of 92 [100%] vs 31 of 92 [34%]), and distant metastases (28 of 30 [93%] vs 20 of 30 [67%]). CONCLUSION: 68 Ga-FAPI-04 PET/CT for tumor re-evaluation showed potential for more accurate performance of gastric, duodenal, and colorectal cancers, thereby improving treatment decision-making.

Role of 68Ga-FAPI-04 PET/CT in the Initial Staging of Esophageal Cancer.

AIM: To investigate the clinical value of 68Ga-FAPI-04 PET/CT for initial staging of esophageal cancer. METHODS: A total of 44 newly diagnosed patients with esophageal cancer were included in the analysis on the basis of postoperative pathology or clinical and radiologic follow-up. RESULTS: All primary lesions showed increased 68Ga-FAPI-04 uptake, with an SUVmax of 14.92 ± 6.91. A total of 561 lymph nodes were verified by surgery (507) or clinical and radiologic follow-up (54), of which 92 lymph nodes were diagnosed as showing metastases. Seventy-five lymph nodes with metastases showed positive findings on 68Ga-FAPI-04, with a diameter of about 1.06 ± 0.53 cm and SUVmax of 8.10±4.71. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for lymph node metastasis detection were 81.5%, 99.3%, 96.6%, 96.2%, and 96.5%, respectively. CONCLUSION: 68Ga-FAPI-04 PET/CT showed good diagnostic performance in detecting lymph node metastases of esophageal cancer.

Mesenteric Mesonephric Adenocarcinoma on 68 Ga-FAPI PET/CT.

ABSTRACT: Mesenteric mesonephric adenocarcinoma is an uncommon mesenteric neoplasm, which was arising from the mesonephric remnant of the female reproductive tract. Herein, we report the 68 Ga-FAPI PET/CT findings in a 66-year-old woman with mesenteric mesonephric adenocarcinoma.

Progress on Denosumab Use in Giant Cell Tumor of Bone: Dose and Duration of Therapy.

Giant cell tumor of bone (GCTB) is an aggressive non-cancerous bone tumor associated with risks of sarcoma and metastasis. Once malignancy occurs, the prognosis is generally poor. Surgery remains the main treatment for GCTB. Multidisciplinary management is a feasible option for patients wherein surgical resection is not an option or for those with serious surgery-related complications. Denosumab is an anti-nuclear factor kappa B ligand approved for the treatment of postmenopausal women with osteoporosis, bone metastases, and advanced or inoperable GCTB. However, the guidelines for treating GCTB are unclear; its short-term efficacy and safety in inoperable patients have been demonstrated. Lengthier therapies (high cumulative doses) or pre-operative adjuvant therapy may be associated with severe complications and high local recurrence rates. Short-term administration helps attain satisfactory local control and functionality. As a result, lately, the impact of different doses and lengths of treatment on the efficacy of denosumab in GCTB treatment, the incidence of complications, and recurrence rates have gained attention. The efficacy and safety of denosumab against GCTB, its impact on imaging assessment, related complications, and recurrence of GCTB were previously reviewed. For further research direction, this paper reviews the progress of studies evaluating the impact of the dose and duration of denosumab therapy for GCTB.