{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:47:35Z","timestamp":1785527255501,"version":"3.56.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100014584","name":"Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014584","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Oncological treatment in a substantial portion of patients with cancer of unknown primary (CUP) remains challenging due to limitations of conventional imaging and positron emission tomography\/computed tomography with\n                      <jats:sup>18<\/jats:sup>\n                      Fluor-fluorodeoxyglucose (\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG-PET\/CT). In head and neck-like CUP (HNCUP), several studies found significantly higher tracer-uptake and detection rates of primary tumors in\n                      <jats:sup>68<\/jats:sup>\n                      Gallium-labeled fibroblast activation protein inhibitor-PET\/CT (\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT). Here, we address a gap in CUP literature by retrospectively evaluating the diagnostic accuracy of both tracer in a head-to-head comparison of patients with single-site and oligometastatic extra-cervical CUP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      13 patients with extra-cervical CUP underwent both\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG- and\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT. Suspicious PET-positive lesions were delineated using the volume of interest-technique (50%-isocontour) followed by analysis of maximum and mean standardized uptake values (SUVmax\/mean), target-to-background ratios (TBRmax\/mean) and tumor-to-tissue ratios (TTRmax\/mean). Descriptive analysis was performed and log-transformation was applied to meet model assumptions and stabilize variance. The difference between log-transformed\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI- and\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG-uptake values was used as outcome variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      21 metastases of 3 patients with single-site and 6 patients with oligometastasized CUP were analyzed. 4 patients with previously extirpated metastases showed no uptake. No increased detection rate of primary tumors could be observed by either tracer. Differences of TBRmax in all metastatic sites and of TTRmax in organ metastases were significant.\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT lead to detection of 5\/21 additional metastases which were not clearly distinguishable in\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG-PET\/CT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Due to higher tissue contrast in organs, our findings suggest that\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT appears favourable compared to\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG-PET\/CT particularly in patients with suspected distant metastases other than lymph nodes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07916-0","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:32:40Z","timestamp":1779431560000},"page":"5833-5843","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["68Ga-FAPI-PET\/CT in extra-cervical CUP: Head-to-Head Comparison of 68Ga-FAPI-46 with 18F-FDG in 13 patients"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1092-5773","authenticated-orcid":false,"given":"Anna-Maria","family":"Spektor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-6201","authenticated-orcid":false,"given":"Sergio Armando","family":"Zapata Bonilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Mildenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Kilburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Driess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kloth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Schreckenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"B\u00e4uerle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kindler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Haberkorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pouyiourou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alwin","family":"Kr\u00e4mer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilmann","family":"Bochtler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"R\u00f6hrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"7916_CR1","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.annonc.2022.11.013","volume":"34","author":"A Kr\u00e4mer","year":"2023","unstructured":"Kr\u00e4mer A, Bochtler T, Pauli C, Baciarello G, Delorme S, Hemminki K, et al. Cancer of unknown primary: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023;34:228\u201346. https:\/\/doi.org\/10.1016\/j.annonc.2022.11.013.","journal-title":"Ann Oncol"},{"key":"7916_CR2","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.critrevonc.2008.09.005","volume":"69","author":"N Pavlidis","year":"2009","unstructured":"Pavlidis N, Fizazi K. Carcinoma of unknown primary (CUP). Crit Rev Oncol Hematol. 2009;69:271\u20138. https:\/\/doi.org\/10.1016\/j.critrevonc.2008.09.005.","journal-title":"Crit Rev Oncol Hematol"},{"key":"7916_CR3","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1038\/nrclinonc.2011.158","volume":"8","author":"C Massard","year":"2011","unstructured":"Massard C, Loriot Y, Fizazi K. Carcinomas of an unknown primary origin--diagnosis and treatment. Nat Rev Clin Oncol. 2011;8:701\u201310. https:\/\/doi.org\/10.1038\/nrclinonc.2011.158.","journal-title":"Nat Rev Clin Oncol"},{"key":"7916_CR4","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1038\/s41571-025-01060-8","volume":"22","author":"M Pouyiourou","year":"2025","unstructured":"Pouyiourou M, Bochtler T, Pauli C, Moch H, Brobeil A, Pantel K, et al. Rethinking cancer of unknown primary: from diagnostic challenge to targeted treatment. Nat Rev Clin Oncol. 2025;22:781\u201399. https:\/\/doi.org\/10.1038\/s41571-025-01060-8.","journal-title":"Nat Rev Clin Oncol"},{"key":"7916_CR5","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1016\/s0140-6736(11)61178-1","volume":"379","author":"N Pavlidis","year":"2012","unstructured":"Pavlidis N, Pentheroudakis G. Cancer of unknown primary site. Lancet. 2012;379:1428\u201335. https:\/\/doi.org\/10.1016\/s0140-6736(11)61178-1.","journal-title":"Lancet"},{"key":"7916_CR6","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.jare.2014.11.007","volume":"6","author":"N Pavlidis","year":"2015","unstructured":"Pavlidis N, Khaled H, Gaafar R. A mini review on cancer of unknown primary site: a clinical puzzle for the oncologists. J Adv Res. 2015;6:375\u201382. https:\/\/doi.org\/10.1016\/j.jare.2014.11.007.","journal-title":"J Adv Res"},{"key":"7916_CR7","doi-asserted-by":"publisher","first-page":"1854","DOI":"10.1093\/annonc\/mdr536","volume":"23","author":"K Hemminki","year":"2012","unstructured":"Hemminki K, Bevier M, Hemminki A, Sundquist J. Survival in cancer of unknown primary site: population-based analysis by site and histology. Ann Oncol. 2012;23:1854\u201363. https:\/\/doi.org\/10.1093\/annonc\/mdr536.","journal-title":"Ann Oncol"},{"key":"7916_CR8","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1053\/j.seminoncol.2008.10.006","volume":"36","author":"JD Hainsworth","year":"2009","unstructured":"Hainsworth JD, Fizazi K. Treatment for patients with unknown primary cancer and favorable prognostic factors. Semin Oncol. 2009;36:44\u201351. https:\/\/doi.org\/10.1053\/j.seminoncol.2008.10.006.","journal-title":"Semin Oncol"},{"key":"7916_CR9","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1007\/s00330-008-1194-4","volume":"19","author":"TC Kwee","year":"2009","unstructured":"Kwee TC, Kwee RM. Combined FDG-PET\/CT for the detection of unknown primary tumors: systematic review and meta-analysis. Eur Radiol. 2009;19:731\u201344. https:\/\/doi.org\/10.1007\/s00330-008-1194-4.","journal-title":"Eur Radiol"},{"key":"7916_CR10","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1007\/s00259-009-1295-6","volume":"37","author":"TC Kwee","year":"2010","unstructured":"Kwee TC, Basu S, Cheng G, Alavi A. FDG PET\/CT in carcinoma of unknown primary. Eur J Nucl Med Mol Imaging. 2010;37:635\u201344. https:\/\/doi.org\/10.1007\/s00259-009-1295-6.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR11","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.220749","volume":"306","author":"Y Mori","year":"2023","unstructured":"Mori Y, Dendl K, Cardinale J, Kratochwil C, Giesel FL, Haberkorn U. FAPI PET: fibroblast activation protein inhibitor use in oncologic and nononcologic disease. Radiology. 2023;306:e220749. https:\/\/doi.org\/10.1148\/radiol.220749.","journal-title":"Radiology"},{"key":"7916_CR12","doi-asserted-by":"publisher","DOI":"10.1038\/s44303-024-00053-z","volume":"2","author":"Y Mori","year":"2024","unstructured":"Mori Y, Novruzov E, Schmitt D, Cardinale J, Watabe T, Choyke PL, et al. Clinical applications of fibroblast activation protein inhibitor positron emission tomography (FAPI-PET). npj Imaging. 2024;2:48. https:\/\/doi.org\/10.1038\/s44303-024-00053-z.","journal-title":"npj Imaging"},{"key":"7916_CR13","doi-asserted-by":"publisher","first-page":"206","DOI":"10.2967\/jnumed.123.266283","volume":"65","author":"X Li","year":"2024","unstructured":"Li X, Lu N, Lin L, Chen Y, Yang S, Wang H, et al. (18)F-FAPI-04 outperforms (18)F-FDG PET\/CT in clinical assessments of patients with pancreatic adenocarcinoma. J Nucl Med. 2024;65:206\u201312. https:\/\/doi.org\/10.2967\/jnumed.123.266283.","journal-title":"J Nucl Med"},{"key":"7916_CR14","doi-asserted-by":"publisher","first-page":"801","DOI":"10.2967\/jnumed.119.227967","volume":"60","author":"C Kratochwil","year":"2019","unstructured":"Kratochwil C, Flechsig P, Lindner T, Abderrahim L, Altmann A, Mier W, et al. (68)Ga-FAPI PET\/CT: tracer uptake in 28 different kinds of cancer. J Nucl Med. 2019;60:801\u20135. https:\/\/doi.org\/10.2967\/jnumed.119.227967.","journal-title":"J Nucl Med"},{"key":"7916_CR15","doi-asserted-by":"publisher","first-page":"365","DOI":"10.2967\/jnumed.123.266556","volume":"65","author":"B Gu","year":"2024","unstructured":"Gu B, Yang Z, Du X, Xu X, Ou X, Xia Z, et al. Imaging of tumor stroma using (68)Ga-FAPI PET\/CT to improve diagnostic accuracy of primary tumors in Head and Neck Cancer of Unknown Primary: a comparative imaging trial. J Nucl Med. 2024;65:365\u201371. https:\/\/doi.org\/10.2967\/jnumed.123.266556.","journal-title":"J Nucl Med"},{"key":"7916_CR16","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1007\/s00259-020-05055-8","volume":"48","author":"S Serfling","year":"2021","unstructured":"Serfling S, Zhi Y, Schirbel A, Lindner T, Meyer T, Gerhard-Hartmann E, et al. Improved cancer detection in Waldeyer\u2019s tonsillar ring by (68)Ga-FAPI PET\/CT imaging. Eur J Nucl Med Mol Imaging. 2021;48:1178\u201387. https:\/\/doi.org\/10.1007\/s00259-020-05055-8.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR17","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1007\/s00259-022-06095-y","volume":"50","author":"Q Shu","year":"2023","unstructured":"Shu Q, Deng M, Hu M, Liu M, Chen X, Chen Y, et al. The additional role of [68Ga]Ga-FAPI-04 PET\/CT in patients with unknown primary lesion with a negative or equivocal [18F]FDG. Eur J Nucl Med Mol Imaging. 2023;50:1442\u201352. https:\/\/doi.org\/10.1007\/s00259-022-06095-y.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR18","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.2967\/jnumed.123.265599","volume":"64","author":"Y Pang","year":"2023","unstructured":"Pang Y, Zhao L, Fang J, Chen J, Meng L, Sun L, et al. Development of FAPI tetramers to improve tumor uptake and efficacy of FAPI radioligand therapy. J Nucl Med. 2023;64:1449\u201355. https:\/\/doi.org\/10.2967\/jnumed.123.265599.","journal-title":"J Nucl Med"},{"key":"7916_CR19","doi-asserted-by":"publisher","first-page":"4740","DOI":"10.1158\/1078-0432.Ccr-23-1983","volume":"29","author":"H Fu","year":"2023","unstructured":"Fu H, Huang J, Zhao T, Wang H, Chen Y, Xu W, et al. Fibroblast activation protein-targeted radioligand therapy with 177Lu-EB-FAPI for metastatic radioiodine-refractory thyroid cancer: first-in-human, dose-escalation study. Clin Cancer Res. 2023;29:4740\u201350. https:\/\/doi.org\/10.1158\/1078-0432.Ccr-23-1983.","journal-title":"Clin Cancer Res"},{"key":"7916_CR20","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1007\/s12149-025-02022-x","volume":"39","author":"I Garc\u00eda Meg\u00edas","year":"2025","unstructured":"Garc\u00eda Meg\u00edas I, Almeida LS, Calapaqu\u00ed Ter\u00e1n AK, Pabst KM, Herrmann K, Giammarile F, et al. FAPI radiopharmaceuticals in nuclear oncology and theranostics of solid tumours: are we nearer to surrounding the hallmarks of cancer? Ann Nucl Med. 2025;39:407\u201323. https:\/\/doi.org\/10.1007\/s12149-025-02022-x.","journal-title":"Ann Nucl Med"},{"key":"7916_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2025.112330","volume":"191","author":"J Maes","year":"2025","unstructured":"Maes J, Cleeren F, Goffin K, Dekervel J, Nafteux P, Topal B, et al. Role of FAPI PET\/CT in cancer of unknown primary (CUP): a systematic review. Eur J Radiol. 2025;191:112330. https:\/\/doi.org\/10.1016\/j.ejrad.2025.112330.","journal-title":"Eur J Radiol"},{"key":"7916_CR22","doi-asserted-by":"publisher","first-page":"4377","DOI":"10.1007\/s00259-021-05307-1","volume":"48","author":"FL Giesel","year":"2021","unstructured":"Giesel FL, Kratochwil C, Schlittenhardt J, Dendl K, Eiber M, Staudinger F, et al. Head-to-head intra-individual comparison of biodistribution and tumor uptake of (68)Ga-FAPI and (18)F-FDG PET\/CT in cancer patients. Eur J Nucl Med Mol Imaging. 2021;48:4377\u201385. https:\/\/doi.org\/10.1007\/s00259-021-05307-1.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR23","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.2967\/jnumed.118.210443","volume":"59","author":"T Lindner","year":"2018","unstructured":"Lindner T, Loktev A, Altmann A, Giesel F, Kratochwil C, Debus J, et al. Development of quinoline-based theranostic ligands for the targeting of fibroblast activation protein. J Nucl Med. 2018;59:1415\u201322. https:\/\/doi.org\/10.2967\/jnumed.118.210443.","journal-title":"J Nucl Med"},{"key":"7916_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s41181-021-00144-x","volume":"6","author":"T Lindner","year":"2021","unstructured":"Lindner T, Altmann A, Giesel F, Kratochwil C, Kleist C, Kr\u00e4mer S, et al. (18)F-labeled tracers targeting fibroblast activation protein. EJNMMI Radiopharm Chem. 2021;6:26. https:\/\/doi.org\/10.1186\/s41181-021-00144-x.","journal-title":"EJNMMI Radiopharm Chem"},{"key":"7916_CR25","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.2967\/jnumed.118.210435","volume":"59","author":"A Loktev","year":"2018","unstructured":"Loktev A, Lindner T, Mier W, Debus J, Altmann A, J\u00e4ger D, et al. A tumor-imaging method targeting cancer-associated fibroblasts. J Nucl Med. 2018;59:1423\u20139. https:\/\/doi.org\/10.2967\/jnumed.118.210435.","journal-title":"J Nucl Med"},{"key":"7916_CR26","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2967\/jnumed.121.261925","volume":"63","author":"M Rohrich","year":"2022","unstructured":"Rohrich M, Leitz D, Glatting FM, Wefers AK, Weinheimer O, Flechsig P, et al. Fibroblast activation protein-specific PET\/CT imaging in fibrotic interstitial lung diseases and lung cancer: a translational exploratory study. J Nucl Med. 2022;63:127\u201333. https:\/\/doi.org\/10.2967\/jnumed.121.261925.","journal-title":"J Nucl Med"},{"issue":"3","key":"7916_CR27","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1111\/caje.12661","volume":"56","author":"MD Webb","year":"2023","unstructured":"Webb MD. Reworking wild bootstrap\u2010based inference for clustered errors. Can J Econ. 2023;56(3):839\u201358.","journal-title":"Can J Econ"},{"key":"7916_CR28","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14174253","author":"DP Liew","year":"2022","unstructured":"Liew DP, R\u00f6hrich M, Loi L, Adeberg S, Syed M, Gutjahr E, et al. FAP-specific signalling is an independent diagnostic approach in ACC and not a surrogate marker of MRI sequences. Cancers (Basel). 2022. https:\/\/doi.org\/10.3390\/cancers14174253.","journal-title":"Cancers (Basel)"},{"key":"7916_CR29","doi-asserted-by":"publisher","first-page":"872","DOI":"10.2967\/jnumed.123.267103","volume":"65","author":"M R\u00f6hrich","year":"2024","unstructured":"R\u00f6hrich M, Daum J, Gutjahr E, Spektor AM, Glatting FM, Sahin YA, et al. Diagnostic potential of supplemental static and dynamic 68Ga-FAPI-46 PET for primary 18F-FDG-negative pulmonary lesions. J Nucl Med. 2024;65:872\u20139. https:\/\/doi.org\/10.2967\/jnumed.123.267103.","journal-title":"J Nucl Med"},{"key":"7916_CR30","doi-asserted-by":"publisher","first-page":"52","DOI":"10.2967\/jnumed.123.266393","volume":"65","author":"AM Spektor","year":"2024","unstructured":"Spektor AM, Gutjahr E, Lang M, Glatting FM, Hackert T, Pausch T, et al. Immunohistochemical FAP expression reflects 68Ga-FAPI PET imaging properties of low- and high-grade intraductal papillary mucinous neoplasms and pancreatic ductal adenocarcinoma. J Nucl Med. 2024;65:52\u20138. https:\/\/doi.org\/10.2967\/jnumed.123.266393.","journal-title":"J Nucl Med"},{"key":"7916_CR31","doi-asserted-by":"publisher","first-page":"779","DOI":"10.2967\/jnumed.120.253062","volume":"62","author":"M R\u00f6hrich","year":"2021","unstructured":"R\u00f6hrich M, Naumann P, Giesel FL, Choyke PL, Staudinger F, Wefers A, et al. Impact of 68Ga-FAPI PET\/CT imaging on the therapeutic management of primary and recurrent pancreatic ductal adenocarcinomas. J Nucl Med. 2021;62:779\u201386. https:\/\/doi.org\/10.2967\/jnumed.120.253062.","journal-title":"J Nucl Med"},{"key":"7916_CR32","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-025-00886-w","volume":"25","author":"J Wessendorf","year":"2025","unstructured":"Wessendorf J, Spektor AM, Aboulmaouahib B, Daum J, Glatting FM, Schlamp K, et al. Image analysis: 68Ga-FAPI-46 PET derived texture parameters improve the differentiation of malignant and benign pulmonary lesions. Cancer Imaging. 2025;25:73. https:\/\/doi.org\/10.1186\/s40644-025-00886-w.","journal-title":"Cancer Imaging"},{"key":"7916_CR33","doi-asserted-by":"publisher","first-page":"8627","DOI":"10.21037\/qims-2025-234","volume":"15","author":"J Wu","year":"2025","unstructured":"Wu J, Meng Y, Li Q, Zhang C, Jiang G. Comparison of [68Ga]Ga-FAPI-04 and [18F]FDG PET\/CT for detection of bone metastases of lung cancer. Quant Imaging Med Surg. 2025;15:8627\u201340. https:\/\/doi.org\/10.21037\/qims-2025-234.","journal-title":"Quant Imaging Med Surg"},{"key":"7916_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1093861","volume":"13","author":"X Liu","year":"2023","unstructured":"Liu X, Liu H, Gao C, Zeng W. Comparison of (68)Ga-FAPI and (18)F-FDG PET\/CT for the diagnosis of primary and metastatic lesions in abdominal and pelvic malignancies: a systematic review and meta-analysis. Front Oncol. 2023;13:1093861. https:\/\/doi.org\/10.3389\/fonc.2023.1093861.","journal-title":"Front Oncol"},{"key":"7916_CR35","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1148\/radiol.211424","volume":"303","author":"L Wang","year":"2022","unstructured":"Wang L, Tang G, Hu K, Liu X, Zhou W, Li H, et al. Comparison of (68)Ga-FAPI and (18)F-FDG PET\/CT in the evaluation of advanced lung cancer. Radiology. 2022;303:191\u20139. https:\/\/doi.org\/10.1148\/radiol.211424.","journal-title":"Radiology"},{"key":"7916_CR36","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.2967\/jnumed.122.263835","volume":"63","author":"KS Roth","year":"2022","unstructured":"Roth KS, Voltin CA, van Heek L, Wegen S, Schom\u00e4cker K, Fischer T, et al. Dual-tracer PET\/CT protocol with [(18)F]-FDG and [(68)Ga]Ga-FAPI-46 for cancer imaging: a proof of concept. J Nucl Med. 2022;63:1683\u20136. https:\/\/doi.org\/10.2967\/jnumed.122.263835.","journal-title":"J Nucl Med"},{"key":"7916_CR37","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s00066-023-02117-2","volume":"200","author":"S Wegen","year":"2024","unstructured":"Wegen S, Weindler J, Voltin CA, van Heek L, Schom\u00e4cker K, Fischer T, et al. Dual-tracer PET\/CT protocol with [(18)F]FDG and [(68)Ga]Ga-FAPI-46 outperforms single-tracer PET\/CT with [(18)F]FDG in different cancer types, resulting in larger functional and gross tumor volume. Strahlenther Onkol. 2024;200:28\u201338. https:\/\/doi.org\/10.1007\/s00066-023-02117-2.","journal-title":"Strahlenther Onkol"},{"key":"7916_CR38","doi-asserted-by":"publisher","first-page":"4355","DOI":"10.1007\/s00330-022-09321-1","volume":"33","author":"Y Miao","year":"2023","unstructured":"Miao Y, Feng R, Guo R, Huang X, Hai W, Li J, et al. Utility of [(68)Ga]FAPI-04 and [(18)F]FDG dual-tracer PET\/CT in the initial evaluation of gastric cancer. Eur Radiol. 2023;33:4355\u201366. https:\/\/doi.org\/10.1007\/s00330-022-09321-1.","journal-title":"Eur Radiol"},{"key":"7916_CR39","doi-asserted-by":"publisher","first-page":"2271","DOI":"10.1007\/s00259-023-06207-2","volume":"50","author":"G Liu","year":"2023","unstructured":"Liu G, Mao W, Yu H, Hu Y, Gu J, Shi H. One-stop [(18)F]FDG and [(68)Ga]Ga-DOTA-FAPI-04 total-body PET\/CT examination with dual-low activity: a feasibility study. Eur J Nucl Med Mol Imaging. 2023;50:2271\u201381. https:\/\/doi.org\/10.1007\/s00259-023-06207-2.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR40","doi-asserted-by":"publisher","first-page":"3221","DOI":"10.1007\/s00259-021-05266-7","volume":"48","author":"J Ferdinandus","year":"2021","unstructured":"Ferdinandus J, Kessler L, Hirmas N, Trajkovic-Arsic M, Hamacher R, Umutlu L, et al. Equivalent tumor detection for early and late FAPI-46 PET acquisition. Eur J Nucl Med Mol Imaging. 2021;48:3221\u20137. https:\/\/doi.org\/10.1007\/s00259-021-05266-7.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR41","doi-asserted-by":"publisher","first-page":"618","DOI":"10.2967\/jnumed.122.264941","volume":"64","author":"M Naeimi","year":"2023","unstructured":"Naeimi M, Choyke PL, Dendl K, Mori Y, Staudinger F, Watabe T, et al. Three-time-point PET analysis of (68)Ga-FAPI-46 in a variety of cancers. J Nucl Med. 2023;64:618\u201322. https:\/\/doi.org\/10.2967\/jnumed.122.264941.","journal-title":"J Nucl Med"},{"key":"7916_CR42","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-025-07636-x","author":"AM Spektor","year":"2025","unstructured":"Spektor AM, van Genabith A, Hoppner J, Walkenbach L, Hielscher T, Kvacskay P, et al. (68)Gallium-labelled fibroblast activation protein inhibitor uptake in joints: a single-center cohort analysis of 268 patients. Eur J Nucl Med Mol Imaging. 2025. https:\/\/doi.org\/10.1007\/s00259-025-07636-x.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7916_CR43","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2967\/jnumed.121.261925","volume":"63","author":"M R\u00f6hrich","year":"2022","unstructured":"R\u00f6hrich M, Leitz D, Glatting FM, Wefers AK, Weinheimer O, Flechsig P, et al. Fibroblast activation protein-specific PET\/CT imaging in fibrotic interstitial lung diseases and lung cancer: A translational exploratory study. J Nucl Med. 2022;63:127\u201333. https:\/\/doi.org\/10.2967\/jnumed.121.261925.","journal-title":"J Nucl Med"},{"key":"7916_CR44","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1258287","volume":"13","author":"D Zou","year":"2023","unstructured":"Zou D, Wang X, Sun Y, Wang X, Lu C, Wang A, et al. Arthralgia adverse events due to immune-checkpoint inhibitors for lung cancer patients: a systematic review and meta-analysis. Front Oncol. 2023;13:1258287. https:\/\/doi.org\/10.3389\/fonc.2023.1258287.","journal-title":"Front Oncol"},{"key":"7916_CR45","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1080\/08998280.2019.1588654","volume":"32","author":"A Jagpal","year":"2019","unstructured":"Jagpal A, Choudhary G, Chokr J. Severe arthritis and tenosynovitis caused by immune checkpoint blockade therapy with pembrolizumab (anti-PD-1 antibody). Proc (Bayl Univ Med Cent). 2019;32:419\u201321. https:\/\/doi.org\/10.1080\/08998280.2019.1588654.","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"7916_CR46","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00409","volume":"8","author":"N Spathas","year":"2018","unstructured":"Spathas N, Economopoulou P, Cheila M, Kotsantis I, Fanouriakis A, Kassara D, et al. Inflammatory arthritis induced by pembrolizumab in a patient with head and neck squamous cell carcinoma. Front Oncol. 2018;8:409. https:\/\/doi.org\/10.3389\/fonc.2018.00409.","journal-title":"Front Oncol"},{"key":"7916_CR47","volume":"3","author":"E Livingstone","year":"2014","unstructured":"Livingstone E, Zimmer L, Vaubel J, Schadendorf D. BRAF, MEK and KIT inhibitors for melanoma: adverse events and their management. Chin Clin Oncol. 2014;3:29.","journal-title":"Chin Clin Oncol"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07916-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-026-07916-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07916-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:10:38Z","timestamp":1785521438000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-026-07916-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":47,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["7916"],"URL":"https:\/\/doi.org\/10.1007\/s00259-026-07916-0","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"17 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the local institutional review board (study number S-115\/2020).","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Figs.\u00a0\n                      \n                      and\n                      \n                      .","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"UH has filed a patent application for quinoline based FAP targeting agents for imaging and therapy in nuclear medicine. UH also has shares of a consultancy group for iTheranostics. No other relevant conflicts of interest exist.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}