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Location: Marriott Marquis
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PQA 05 - PQA 05: Breast Cancer and Nonmalignant Disease Poster Q&A

2703 - Diagnostic Value of 18F-FAPI-04 PET/CT for Identification of Benign Breast Lesions and Breast Cancers: Comparison with Traditional Imaging Examinations

Monday, September 30, 2024
3:00 PM – 4:00 PM ET
Location: Hall C

Screen: 16

J. Liu1,2, S. Wang1, K. Zhao1, J. Yu1, and J. Liu1; 1Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, 2Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China

Purpose/Objective(s): 18F-FAPI-04 has been demonstrated safe and offered high specificity and high contrast for fibroblast activation protein imaging. In this study, we investigated 18F-FAPI-04 PET/CT for diagnosis of benign breast lesions (BBL) and breast cancers (BC) in clinic.

Materials/

Methods: Untreated 48 patients with 58 breast lesions underwent 18F-FAPI-04 PET/CT. Subsequently, the breast lesions were histopathologically confirmed through biopsy or surgery. Breast Imaging-Reporting and Data System (BI-RADS) grades from traditional imaging examinations (ultrasound, mammography and magnetic resonance imaging (MRI)) and semiquantitative parameters from 18F-FAPI-04 PET/CT were compared between BBL and BC. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy and provide the cutoff value.


Results: Except 18F-FAPI-avid tumor volume (FTV) (P = 0.076), the BI-RADS grades for ultrasound, mammography and MRI, SUVmax, SUVmean, SUVpeak, total lesion FAP expression (TLF), LBRblood, LBRmuscle, LBRbone, and LBRbreast (the SUVmax of the breast lesions divided by the SUVmean of blood pool, muscle, bone, and contralateral breast) were significantly higher in BC than in BBL (all P < 0.01). ROC curve analysis identified above significantly different paraments were predictors of BC (all P < 0.001). Area under the curve (AUC) of LBRbreast was the largest (1.000). With cutoff 3.95, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of LBRbreast were both 100% for differentiating BC from BBL. Ultrasound was the most common imaging examination for breast lesions, BI-RADS grades 3 and 4a were proved BBL, BI-RADS grades 4b, 4c and 5 were proved BC (P= 0.000) in this study. The AUC of ultrasound was the smallest (AUC = 0.935, sensitivity =92.3%, specificity = 89.7%).

Conclusion: 18F-FAPI-04 PET/CT parameters were significantly higher in BC than in BBL. Except FTV, the rest of parameters are valuable for distinguishing BBL and BC. When the cutoff of LBRbreast is 3.95, LBRbreast has the best diagnostic efficacy with sensitivity and specificity = 100%.