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RETRACTED ARTICLE: Superiority of [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT to [18F]FDG PET/CT in delineating the primary tumor and peritoneal metastasis in initial gastric cancer

  • Gastrointestinal
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This article was retracted on 18 January 2023

This article has been updated

Abstract

Objective

This study aimed to compare [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT with [18F]FDG PET/CT in the evaluation of initial gastric cancer.

Methods

We retrospectively compared [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT with [18F]FDG PET/CT in patients with initial gastric cancer from September 2020 to March 2021. Lesion detectability and the uptake of lesions quantified by the maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR) were compared between the two modalities using the Wilcoxon signed-rank test, Mann–Whitney U test, and McNemar’s chi-square test.

Results

A total of 61 patients (37 males, aged 23–81 years) were included, of which 22 underwent radical gastrectomy. For primary lesions, higher uptake of [68Ga]Ga-FAPI-04/[18F]FAPI-42 was observed compared to [18F]FDG (median SUVmax, 14.60 vs 4.35, p < 0.001), resulting in higher positive detection using [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT than [18F]FDG PET/CT (95.1% vs 73.8%, p < 0.001), particularly for tumors with signet-ring cell carcinoma (SRCC) (96.4% vs 57.1%, p < 0.001). [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT detected more positive lymph nodes than [18F]FDG PET/CT (637 vs 407). However, both modalities underestimated N staging compared to pathological N staging. [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT showed a higher sensitivity (92.3% vs 53.8%, p = 0.002) and peritoneal cancer index score (18 vs 3, p < 0.001) in peritoneum metastasis and other suspect metastases compared to [18F]FDG PET/CT.

Conclusion

Our findings indicate that [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT outperformed [18F]FDG PET/CT in the evaluation of primary tumors with SRCC and peritoneum metastasis in initial gastric cancer. However, no clinically useful improvement was seen in N staging.

Key Points

• The uptake of [68Ga]Ga-FAPI-04/[18F]FAPI-42 in primary tumor and metastasis was intensely higher than that of [18F]FDG (p < 0.001) in 61 patients with initial gastric cancer.

• [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT had a higher sensitivity detection in primary tumors (95.1% vs 73.8%, p < 0.001) and peritoneal metastases (92.3% vs 53.8%, p = 0.002) than [18F]FDG PET/CT.

• [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT depicted more positive lymph nodes than [18F]FDG PET/CT (637 vs 407); however, both underestimated N staging compared to pathological N staging.

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Abbreviations

CT:

Computed tomography

FAPI:

Fibroblast activation protein inhibitor

FDG:

Fluorodeoxyglucose

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

ROIs:

Regions of interest

SRCC:

Signet-ring cell carcinoma

SUVmax:

Maximum standardized uptake value

TBR:

Target-to-background ratio

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Funding

This work was supported by the National Natural Science Foundation of China (No. 91949121), Nanfang Hospital Talent Introduction Foundation of Southern Medical University (No. 123456).

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Author notes

  1. Lilan Fu and Shun Huang contributed equally to this work.

Authors and Affiliations

  1. Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China

    Lilan Fu, Shun Huang, Hubing Wu, Ye Dong, Fei Xie, Ruihe Wu, Kemin Zhou, Ganghua Tang & Wenlan Zhou

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  1. Lilan Fu
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  2. Shun Huang
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Correspondence to Ganghua Tang or Wenlan Zhou.

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The scientific guarantor of this publication is the corresponding author Wenlan Zhou.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Written informed consent was waived by the institutional review board due to the retrospective and observational nature of the study.

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This article has been retracted. Please see the retraction notice for more detail: https://doi.org/10.1007/s00330-022-09386-y

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Fu, L., Huang, S., Wu, H. et al. RETRACTED ARTICLE: Superiority of [68Ga]Ga-FAPI-04/[18F]FAPI-42 PET/CT to [18F]FDG PET/CT in delineating the primary tumor and peritoneal metastasis in initial gastric cancer. Eur Radiol 32, 6281–6290 (2022). https://doi.org/10.1007/s00330-022-08743-1

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  • DOI: https://doi.org/10.1007/s00330-022-08743-1

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