Figure: Novel 68Ga-FAPI PET/CT offers oncologic staging without COVID-19 vaccine-related complications.
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Credit: Tristan T. Image courtesy of Demmert et al., Department of Nuclear Medicine, University Hospital Essen.
Reston, Va-A novel imaging agent, 68Ga-FAPI may reduce the number of false-positive PET/CT results in cancer patients recently vaccinated against COVID-19. New research published ahead of print Journal of Nuclear Medicine It shows 68Ga-FAPI imaging offers superior lesion detection in locoregional lymph nodes without the uptake of vaccine-associated tracers that are common. 18F-FDG imaging. This can help prevent costly follow-up and erroneous management decisions for cancer patients.
A side effect of the COVID-19 vaccine is 18f–mRNA produced by FDG (the most commonly used PET imaging agent) vaccine is taken up by immune cells in response to inflammatory stimuli. This is known as a reactive uptake and does not always indicate that a tumor is present.
Researcher Tristan T. of the Department of Nuclear Medicine at Essen University Hospital in Germany. “This observation is concerning for vulnerable groups, such as oncologic patients who routinely undergo both the COVID-19 booster shot and medical imaging,” says Demmert. False positive results 18F-FDG PET may trigger incorrect management decisions due to reactive uptake.”
To find a way to avoid these false positives, the researchers compared two radiotracers, 68Ga-FAPI and 18F-FDG. Using a large prospective imaging registry, researchers investigated 11 oncologic patients who received the COVID-19 vaccine within six weeks, 68Ga-FAPI and 18There was F-FDG imaging on the same day, and documentation of tracer uptake in local lymph nodes. Visual reading of images was performed by two nuclear medicine physicians.
Significant lymph node involvement adjacent to the injection site was noted in 11/11 patients 18with F-FDG PET/CT vs. 0/11 68Ga-FAPI PET/CT. Also, 18F-FDG detected 73 percent of tumor lesions 68Ga-FAPI detected 94 percent of all tumor lesions.
“In patients with suspected tumors in the axillary region, an expensive follow-up is often recommended to avoid wrong patient treatment. According to our results, this could have been prevented using 68Ga-FAPI, which will allow higher tumor detection at the same time,” noted Demert. “Considering that more booster vaccinations are expected, 68Ga-FAPI may show its potential to avoid vaccine-related misinterpretation in PET/CT while providing equivalent tumor detection.”
This study was made available online in November 2022.
The authors of “the novel 68“Ga-FAPI PET/CT offers oncologic staging without the complications associated with the Covid-19 vaccine” by Tristan T. Demmert, Ines Merrick, Katharina Leukerth, Ken Hermann, and Wolfgang P. Fendler, Department of Nuclear Medicine, West German Cancer Center , University Duisburg-Essen, Essen, Germany, and German Cancer Consortium (DKTK), partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Essen, Germany; Kelsey L. Pomykala, Institute for AI in Medicine (IKIM) , University Medicine, Essen, Germany; Jens Sieveke, German Cancer Consortium (DKTK), partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Essen, Germany, and Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Benedikt M. Schaarschmidt, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Universi ty of Duisburg-Essen, Essen, Germany; and Rainer Hamacher, German Cancer Consortium (DKTK), partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Essen, Germany, and Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Germany.
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Journal
Journal of Nuclear Medicine
Essay Title
Novel 68Ga-FAPI PET/CT offers oncologic staging without COVID-19 vaccine-related harm
COI statement
Katharina Lueckarath reports fees from SOFIE Biosciences (consultant) and Enlaza Therapeutics (consultant). Rainer Hamacher is supported by the Clinician Scientist Program of the Medicine Essen Clinician Scientist Academy (UMEA) sponsored by the Faculty of Medicine and the Deutsche Forschungsgemeinschaft (DFG) and has received travel grants from Lilly, Novartis and Pharmamer as well as fees from Lilly and Pharmamer. Jens T. Siveke has received honoraria as a consultant or for continuing medical education presentations from AstraZeneca, Bayer, Bristol-Myers Squibb, Eisbach Bio, Immunocore, Novartis, Roche/Genentech, Servier; His institution receives research funding from Bristol-Myers Squibb, Celgene, Eisbach Bio, Roche/Genentech; He owns and serves on the board of directors of Pharma15 outside of the submitted work. Benedikt M. Schaarschmidt received a research grant from PharmaCept for an investigator-initiated study unrelated to this paper. Personal fees from Ken Herrmann Bayer, personal fees from Sofie Biosciences and others, personal fees from SIRTEX, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from BTG, IPSEN Personal fees from, Personal fees from Siemens Healthineers, Personal fees from GE Healthcare, Personal fees from Amgen, Personal fees from Novartis, Personal fees from ymabs, Personal fees from Aktis Oncology, Personal fees from Theragnostics, Personal fees from Pharma15, Submissions outside work given Wolfgang P. Fendler reports outside fees from SOFIE Bioscience (research funding), Janssen (consultant, speaker’s bureau), Calix (consultant), Bayer (consultant, speaker’s bureau, research fund), Parexel (image review), and AAA (speakers’ bureau). work All disclosures were outside of the submitted work.
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