Early image acquisition Ga-FAPI-46-PET/CT in prone position is promising in the workup of rectosigmoid and anal carcinoma.

Eur J Nucl Med Mol Imaging

Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Published: July 2025


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Article Abstract

Purpose: To overcome difficulties with regard to anatomic discrimination of intrapelvic tumors and non-specific intrapelvic uptake (i.e. excreted activity in the urinary bladder) by early acquisition of FAPI-PET in prone position.

Methods: 15 patients with rectosigmoid (RSC) and squamous cell carcinoma of the anus (SCCA) underwent early-imaging Ga-FAPI-46-PET/CT-scans in prone position 5.9 ± 1.3 min after radiotracer injection. SUV and metric values for primary tumors, metastases, bladder and background tissues were measured. Tumor-to-background ratios (TBR) were calculated.

Results: Despite early acquisition, SUV was already high in tumors and metastases, leading to high TBR. A sufficient, on average at least 2.56 ± 0.66 cm, spatial distance between tumor and bladder uptake was observed in all cases.

Conclusion: An early-imaging protocol in prone position with Ga-FAPI-46-PET/CT presents a viable option for non-invasive staging of SCCA and RSC with high TBR and good spatial separation from the urinary bladder.

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http://dx.doi.org/10.1007/s00259-025-07451-4DOI Listing

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