Dual-Tracer PET/CT Protocol with [<sup>18</sup>F]-FDG and [<sup>68</sup>Ga]Ga-FAPI-46 for Cancer Imaging: A Proof of Concept.

Roth, Katrin S; Voltin, Conrad-Amadeus; van Heek, Lutz; Wegen, Simone; Schomäcker, Klaus; Fischer, Thomas; Marnitz, Simone; Drzezga, Alexander et al. · J Nucl Med · 2022

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Abstract

Imaging studies with PET tracers acting as fibroblast activation protein inhibitors (FAPIs) show promising results that could usefully complement [<sup>18</sup>F]-FDG in cancer imaging. <b>Methods:</b> All patients received [<sup>18</sup>F]-FDG PET/CT and dual-tracer PET/CT after an additional injection of [<sup>68</sup>Ga]Ga-FAPI-46 after the [<sup>18</sup>F]-FDG PET/CT. Two readers visually compared detection rate and analyzed target-to-background ratios for tumor and metastatic tissue in single- and dual-tracer PET/CT. <b>Results:</b> Detection rate in dual-tracer PET/CT was visually as good as that in single-tracer PET/CT in 4 patients and superior in 2 patients, whereas target-to-background ratios were significantly higher in dual-tracer PET/CT. <b>Conclusion:</b> Dual-tracer [<sup>18</sup>F]-FDG/[<sup>68</sup>Ga]Ga-FAPI-46 PET/CT within a single session is feasible and has potential. The dual-tracer approach may have superior sensitivity to [<sup>18</sup>F]-FDG PET/CT alone without compromising individual assessment of either scan.

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