{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:58:14Z","timestamp":1788933494016,"version":"build-2803163510"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p><jats:sup>68<\/jats:sup>Ga-FAPI (fibroblast activation protein inhibitor) is a novel and highly promising radiotracer for PET\/CT imaging. The aim of this retrospective analysis is to explore the potential of FAPI-PET\/CT in gynecological malignancies. We assessed biodistribution, tumor uptake, and the influence of pre- or postmenopausal status on tracer accumulation in hormone-sensitive organs. Furthermore, a comparison with the current standard oncological tracer <jats:sup>18<\/jats:sup>F-FDG was performed in selected cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>A total of 31 patients (median age 59.5) from two centers with several gynecological tumors (breast cancer; ovarian cancer; cervical cancer; endometrial cancer; leiomyosarcoma of the uterus; tubal cancer) underwent <jats:sup>68<\/jats:sup>Ga-FAPI-PET\/CT. Out of 31 patients, 10 received an additional <jats:sup>18<\/jats:sup>F-FDG scan within a median time interval of 12.5\u00a0days (range 1\u201376). Tracer uptake was quantified by standardized uptake values (SUV)max and (SUV)mean, and tumor-to-background ratio (TBR) was calculated (SUVmax tumor\/ SUVmean organ). Moreover, a second cohort of 167 female patients with different malignancies was analyzed regarding their FAPI uptake in normal hormone-responsive organs: endometrium (<jats:italic>n<\/jats:italic>\u2009=\u2009128), ovary (<jats:italic>n<\/jats:italic>\u2009=\u200964), and breast (<jats:italic>n<\/jats:italic>\u2009=\u2009147). These patients were categorized by age as premenopausal (&lt;35 years; <jats:italic>n<\/jats:italic>\u2009=\u200912), postmenopausal (&gt;65 years; <jats:italic>n<\/jats:italic>\u2009=\u200968), and unknown menstrual status (35\u201365 years; <jats:italic>n<\/jats:italic>\u2009=\u200987), followed by an analysis of FAPI uptake of the pre- and postmenopausal group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In 8 out of 31 patients, the primary tumor was present, and all 31 patients showed lesions suspicious for metastasis (<jats:italic>n<\/jats:italic>\u2009=\u200981) demonstrating a high mean SUVmax in both the primary (SUVmax 11.6) and metastatic lesions (SUVmax 9.7). TBR was significantly higher in <jats:sup>68<\/jats:sup>Ga-FAPI compared to <jats:sup>18<\/jats:sup>F-FDG for distant metastases (13.0 vs. 5.7; <jats:italic>p<\/jats:italic>\u00a0=\u20090.047) and by trend for regional lymph node metastases (31.9 vs 27.3; <jats:italic>p<\/jats:italic>\u00a0=\u20090.6). Biodistribution of <jats:sup>68<\/jats:sup>Ga-FAPI-PET\/CT presented significantly lower uptake or no significant differences in 15 out of 16 organs, compared to <jats:sup>18<\/jats:sup>F-FDG-PET\/CT. The highest uptake of all primary lesions was obtained in endometrial carcinomas (mean SUVmax 18.4), followed by cervical carcinomas (mean SUVmax 15.22). In the second cohort, uptake in premenopausal patients differed significantly from postmenopausal patients in endometrium (11.7 vs 3.9; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and breast (1.8 vs 1.0; <jats:italic>p<\/jats:italic>\u2009=\u20090.004), whereas no significant\u00a0difference concerning ovaries (2.8 vs 1.6; <jats:italic>p<\/jats:italic>\u2009=\u20090.141) was observed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Due to high tracer uptake resulting in sharp contrasts in primary and metastatic lesions and higher TBRs than <jats:sup>18<\/jats:sup>F-FDG-PET\/CT, <jats:sup>68<\/jats:sup>Ga-FAPI-PET\/CT presents a promising imaging method for staging and follow-up of gynecological tumors. The presence or absence of the menstrual cycle seems to correlate with FAPI accumulation in the normal endometrium and breast. This first investigation of FAP ligands in gynecological tumor entities supports clinical application and further research in this field.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-021-05378-0","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T04:05:33Z","timestamp":1622261133000},"page":"4089-4100","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":177,"title":["68Ga-FAPI-PET\/CT in patients with various gynecological malignancies"],"prefix":"10.1007","volume":"48","author":[{"given":"Katharina","family":"Dendl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan A.","family":"Koerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Finck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kgomotso M. 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Oncol Lett. 2015;10(1):34\u201342. https:\/\/doi.org\/10.3892\/ol.2015.3151.","journal-title":"Oncol Lett"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-021-05378-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-021-05378-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-021-05378-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T05:26:34Z","timestamp":1632979594000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-021-05378-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,29]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["5378"],"URL":"https:\/\/doi.org\/10.1007\/s00259-021-05378-0","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,29]]},"assertion":[{"value":"18 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was approved by the local institutional review board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Patients provided a written informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"SAK reports grants from Viewray Inc., outside the submitted work.JD reports grants from Viewray Inc., CRI \u2013 The Clinical Research Institute GmbH, Accuray International Sari, RaySearch Laboratories AB, Vision RT Limited, Merck Serono GmbH, Astellas Pharma GmbH, Astra Zeneca GmbH, Siemens Healthcare GmbH, Solution Akademie GmbH, Ergomed PLC Surrey Research Park, Quintiles GmbH, Pharmaceutical Research Associates GmbH, Boehringer Ingelheim Pharma GmbH&CoKG, PTW-Freiburg Dr. Pychlau GmbH, Nanobiotix S.A, outside the submitted work.UH, CK, and FG are named in a patent application (EP 18155420.5) for quinolone-based FAP-targeting agents for imaging and therapy in nuclear medicine. CK, UH, and FLG also have shares of a consultancy group for iTheranostics.All other authors declare no potential conflicts of interest relevant to this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}