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Войти в исследования European journal of nuclear medicine and molecular imaging · 2026
Exploratory evaluation of early 68Ga-FAPI-46 PET/CT volume-based parameters in systemic sclerosis-associated interstitial lung disease.
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Tai Sarah Beishan, Chua Wei Ming, Ng Cherie Wei Qi, Noviani Maria, Tham Wei Ping, Saffari Seyed Ehsan, Lam Winnie Wing Chuen, Ng David Chee Eng, Low Adrian Shoen Choon Seng, Xie Wanying, Low Andrea Hsiu Ling
Аннотация
PURPOSE: Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is a severe complication of SSc, characterised by progressive fibrosis and inflammation. Current diagnostic tools do not accurately differentiate progressors from non-progressors, limiting timely intervention. 68Ga-FAPI-46 is a positron emission tomography (PET) tracer targeting fibroblast activation protein alpha (FAP), a marker of activated fibroblasts, with high affinity and retention. Optimal imaging timepoints and PET parameters for 68Ga-FAPI-46 PET/CT imaging in fibroinflammatory disorders remain undefined. This exploratory study investigated early versus late 68Ga-FAPI-46 PET parameters in evaluating SSc-ILD.
METHODS: Early (10 min) and late (60 min) 68Ga-FAPI-46 PET parameters were compared between progressive (n = 8) and non-progressive SSc-ILD (n = 14), defined by INBUILD trial criteria. PET parameters were correlated with pulmonary function test (PFT) and HRCT parameters. Optimal thresholds for identified PET parameters were determined by closest-to-(0,1) criterion.
RESULTS: Early total lesion FAPI uptake (median TL-FAPI10min 1245 vs. 714, p = 0.020) and affected lung volume (median AV10min 514 ml vs. 368 ml, p = 0.042) were significantly higher in progressors than non-progressors. Early PET parameters showed stronger, more consistent correlations with PFT and quantitative HRCT parameters than late PET parameters. Volume-based compared to intensity-based PET parameters more consistently correlated with PFT and quantitative HRCT parameters. TL-FAPI10min threshold of 928 had the best diagnostic performance (AUC 0.80).
CONCLUSION: This exploratory study showed that 68Ga-FAPI-46 PET/CT imaging, specifically early volume-based PET parameters, was associated with patients with recent disease progression of SSc-ILD. Prospective validation in treatment-response studies is needed to confirm the clinical utility of these PET parameters and their identified preliminary thresholds.
METHODS: Early (10 min) and late (60 min) 68Ga-FAPI-46 PET parameters were compared between progressive (n = 8) and non-progressive SSc-ILD (n = 14), defined by INBUILD trial criteria. PET parameters were correlated with pulmonary function test (PFT) and HRCT parameters. Optimal thresholds for identified PET parameters were determined by closest-to-(0,1) criterion.
RESULTS: Early total lesion FAPI uptake (median TL-FAPI10min 1245 vs. 714, p = 0.020) and affected lung volume (median AV10min 514 ml vs. 368 ml, p = 0.042) were significantly higher in progressors than non-progressors. Early PET parameters showed stronger, more consistent correlations with PFT and quantitative HRCT parameters than late PET parameters. Volume-based compared to intensity-based PET parameters more consistently correlated with PFT and quantitative HRCT parameters. TL-FAPI10min threshold of 928 had the best diagnostic performance (AUC 0.80).
CONCLUSION: This exploratory study showed that 68Ga-FAPI-46 PET/CT imaging, specifically early volume-based PET parameters, was associated with patients with recent disease progression of SSc-ILD. Prospective validation in treatment-response studies is needed to confirm the clinical utility of these PET parameters and their identified preliminary thresholds.