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<p>Fibroblasts associated to carcinomas express fibroblast activation protein (FAP). FAP-targeted imaging with Positron Emission Tomography (PET) with <sup>68</sup>Ga-FAP inhibitors (FAPi-PET), is a pan-tumoral imaging that enables in-vivo visualization of the tumor stroma and detection of neoplastic foci in various cancers. The primary aim was to evaluate the diagnostic performance of FAPi-PET in detecting locally advanced gastric cancers (LAGC), including the evaluation of peritoneal disease (PD). Thirty consecutive patients with LAGC were included in this prospective study between Nov-2023 and Nov-2024 at the European Institute of Oncology in Milano. All patients had an indication to staging laparoscopy and underwent FAPi-PET within 1 week prior to surgery. Significant gastric expression of FAP (mean SUVmax 13,12 ± 5,9 SD) was detected in 29 FAPi-PET scans. The only GC without detectable gastric uptake was an early GC. The sensitivity of FAPi-PET for the identification of primary tumor was 96,7%. PD was suspected based on FAPi-PET imaging in 2 patients (mean SUVmax of 7.55 ±2.19 SD). At staging laparoscopy PD was observed in only 1 patient. Conversely, in 2 cases with a negative preoperative FAPi-PET, PD was observed during laparoscopy,. The accuracy of FAPi-PET for PD was 90% (sensitivity 33,3%, specificity 96,3%). FAPi-PET showed a high detection rate for LAGC, even in cases with diffuse histology. This technique appears to provide high specificity for PD. These promising preliminary findings, support further validation of FAPi-PET in upper-GI malignancies to evaluate its impact on clinical practice for staging and treating LAGC.</p>

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Preliminary results of a prospective study on FAPi-PET for staging of locally advanced gastric cancer

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Uberto Fumagalli Romario,
  • Stefano de Pascale,
  • Annaclara Sileo,
  • Chiara Alessandra Cella,
  • Lighea Simona Maria Airò Farulla,
  • Emilio Bertani,
  • Nicola Fazio,
  • Lorenzo Gervaso,
  • Francesco Mattana,
  • Francesco Ceci

摘要

Fibroblasts associated to carcinomas express fibroblast activation protein (FAP). FAP-targeted imaging with Positron Emission Tomography (PET) with 68Ga-FAP inhibitors (FAPi-PET), is a pan-tumoral imaging that enables in-vivo visualization of the tumor stroma and detection of neoplastic foci in various cancers. The primary aim was to evaluate the diagnostic performance of FAPi-PET in detecting locally advanced gastric cancers (LAGC), including the evaluation of peritoneal disease (PD). Thirty consecutive patients with LAGC were included in this prospective study between Nov-2023 and Nov-2024 at the European Institute of Oncology in Milano. All patients had an indication to staging laparoscopy and underwent FAPi-PET within 1 week prior to surgery. Significant gastric expression of FAP (mean SUVmax 13,12 ± 5,9 SD) was detected in 29 FAPi-PET scans. The only GC without detectable gastric uptake was an early GC. The sensitivity of FAPi-PET for the identification of primary tumor was 96,7%. PD was suspected based on FAPi-PET imaging in 2 patients (mean SUVmax of 7.55 ±2.19 SD). At staging laparoscopy PD was observed in only 1 patient. Conversely, in 2 cases with a negative preoperative FAPi-PET, PD was observed during laparoscopy,. The accuracy of FAPi-PET for PD was 90% (sensitivity 33,3%, specificity 96,3%). FAPi-PET showed a high detection rate for LAGC, even in cases with diffuse histology. This technique appears to provide high specificity for PD. These promising preliminary findings, support further validation of FAPi-PET in upper-GI malignancies to evaluate its impact on clinical practice for staging and treating LAGC.