{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:11:21Z","timestamp":1789827081659,"version":"4.0.1"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Biotherapy and Radiopharmaceuticals"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Digestive system malignancies frequently recur because occult lesions and microscopic residual disease may persist despite apparently complete resection. The authors evaluated an integrated fibroblast activation protein (FAP)-targeted theranostic workflow combining preoperative [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-FAPI-46 positron emission tomography\/computed tomography (PET\/CT), intraoperative radiopharmaceutical-guided robotic surgery, and postoperative [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-FAPI-46 therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In this prospective translational feasibility study, 36 patients with colorectal (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24), gastric (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 8), or pancreatic (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4) adenocarcinoma underwent preoperative [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-FAPI-46 PET\/CT and radiopharmaceutical-guided robotic resection. Patients with postoperative residual disease were considered for [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-FAPI-46 therapy. Imaging, surgical, pathological, therapeutic, dosimetric, and safety outcomes were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-FAPI-46 PET\/CT increased lesion detection from 42.6% \u00b1 10.7% to 75.8% \u00b1 11.9% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.004) and correlated with operative\/pathological lesion burden (\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.7736,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Radioguided surgery significantly reduced target lesion counts after excision (536 \u00b1 219 vs. 92 \u00b1 46 counts\/s,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and improved lesion localization, additional lesion retrieval, and margin-negative resection. Residual disease was identified in 14 of 36 patients; 10 received [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-FAPI-46. In the treated residual disease subset, residual lesion maximum standardized uptake value and circulating tumor DNA decreased after therapy, with preliminary short-term residual disease control observed in 71% of evaluable cases. Organ-absorbed doses were modest, 9 of 10 treated patients had no grade \u22653 toxicity, and no treatment-limiting safety signal was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This FAP-targeted perioperative theranostic strategy was feasible and showed promising imaging, surgical, therapeutic, and safety performance in digestive system malignancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10849785261486278","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:05:34Z","timestamp":1789650334000},"source":"Crossref","is-referenced-by-count":0,"title":["Theranostic Radiopharmaceutical-Guided Robotic Surgery for Precision Tumor Resection and Targeted Elimination of Residual Disease in Digestive System Malignancies"],"prefix":"10.1177","author":[{"given":"Yu","family":"Wen","sequence":"first","affiliation":[{"name":"Patient Service Center, The Second Hospital of Jilin University, Jilin Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Colorectal and Anal Surgery, The Second Hospital of Jilin University, Jilin Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinchun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Jilin University, Jilin Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7980-0995","authenticated-orcid":false,"given":"Huaifeng","family":"Ta","sequence":"additional","affiliation":[{"name":"Operating Room, The Second Hospital of Jilin University, Jilin Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"1.Han C Huang C Fang Y. 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Circulating tumor DNA as a marker of minimal residual disease in colorectal cancer. Clin Adv Hematol Oncol 2020;18(12):791\u2013792.","journal-title":"Clin Adv Hematol Oncol"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.jmedchem.5c00637"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17091401"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.04.034"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-007-0476-4"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.06.002"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.08.051"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40336-017-0235-x"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-023-01627-0"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41573-020-0073-9"},{"issue":"9","key":"e_1_3_3_24_1","first-page":"589","article-title":"Radiotheranostics: A roadmap for future development","volume":"19","author":"Herrmann K","year":"2020","unstructured":"23.Herrmann K, , Schwaiger M, , Lewis JS, et al. Radiotheranostics: A roadmap for future development. 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