Abstract
Purpose
Penile cancer is a rare entity and has a good prognosis in localized stage. Delayed surgical treatment of lymphatic disease is associated with poor overall survival but conventional imaging cannot detect occult lymph node metastasis sufficiently. Imaging cancer related fibroblasts has shown promising results as non-invasive staging tool in various tumor entities but has not yet been evaluated in penile cancer.
Methods
In this single-center pilot study, patients planned for surgical treatment for penile cancer underwent preoperatively [68Ga]Ga-FAPI-46 PET/CT. Post-operative histopathology was compared to [68Ga]Ga-FAPI-46 PET/CT results.
Results
From January 2022 to June 2022, a total number 11 patients with histopathologically proven penile cancer underwent surgery and received [68Ga]Ga-FAPI-46 PET/CT prior therapy. 8 primary tumor sites and 4 lymph node regions were analyzed. FAPI uptake was increased on primary tumor site (SUVmax 16.2 (9.1 – 25.8)). Histopathological proven lymph node regions showed highly increased FAPI uptakes (SUVmax 17.9 (16.4 – 23.5) on [68Ga]Ga-FAPI-46 PET/CT.
Conclusion
In this first pilot cohort, there were no false-positive FAPI uptake which might allow the detection of occult lymph node metastasis by [68Ga]Ga-FAPI-46 PET/CT and might consequently lead to omitting lymph node regions during surgery that had no increased FAPI uptake pre-operatively.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Funding
Lena M. Unterrainer is funded by the Bayerische Zentrum für Krebsforschung (BZKF) and from the Munich Clinician Scientist Program (MCSP).
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Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Lennert Eismann, Stephan T. Ledderose, Benazir Enzinger, Elena Berg, Thilo Westhofen, Severin Rodler, Gerald B. Schulz, Johannes Toms, Adrien Holzgreve, Franz J. Gildehaus, Matthias Brendel, Clemens C. Cyran, Marcus Unterrainer, Christian G. Stief, Peter Bartenstein, Boris Schlenker and Lena Unterrainer.
The first draft of the manuscript was written by Lennert Eismann and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Retrospective analysis of data was granted by the institutional Ethics Committee of Ludwig-Maximilian University Munich (No.: 22–1093).
Informed consent
Informed consent for PET/CT imaging prior to the examination was obtained from all individual participants included in the study.
Conflicts of interest
The authors have no relevant financial or non-financial interests to disclose.
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Eismann, L., Ledderose, S.T., Enzinger, B. et al. [68Ga]Ga-FAPI-46 PET/CT for penile cancer – a feasibility study. Eur J Nucl Med Mol Imaging (2024). https://doi.org/10.1007/s00259-024-06763-1
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DOI: https://doi.org/10.1007/s00259-024-06763-1