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68GaGa-FAPI versus 2-18FFDG PET/CT in patients with autoimmune thyroiditis: a case control study
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68GaGa-FAPI versus 2-18FFDG PET/CT in patients with autoimmune thyroiditis: a case control study
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Journal Article
68GaGa-FAPI versus 2-18FFDG PET/CT in patients with autoimmune thyroiditis: a case control study
2024
Overview
Purpose
Radiolabelled fibroblast activation protein inhibitors (FAPIs) are becoming increasingly important for imaging various tumour diseases. However, it is essential to be aware of potential pitfalls. Here, we investigate FAP expression in the thyroid gland in autoimmune thyroiditis (AIT).
Methods
AIT patients with pathological thyroid uptake on [
68
Ga]Ga-FAPI PET were compared with glucose metabolism on 2-[
18
F]FDG PET in terms of SUV
max
/SUV
peak
/SUV
mean
/tissue-to-background ratio (TBR), and with a healthy control group.
Results
Between September 2019 and July 2021, 6 patients presented with a visually increased thyroid uptake and TBR on [
68
Ga]Ga-FAPI PET. In the retrospective clinical work-up, all patients had known or newly diagnosed AIT. Compared to a matched healthy control group, FAP expression and glucose metabolism were significantly increased ([
68
Ga]Ga-FAPI (SUV
peak
): 7.0 vs. 1.7;
p
= 0.004/(TBR
bloodpool
): 6.8 vs. 1.7;
p
= 0.002; 2-[
18
F]FDG (SUV
peak
): 3.9 vs. 1.4;
p
= 0.004/(TBR
bloodpool
): 4.0 vs. 1.2;
p
= 0.041). However, there was no significant difference in median uptake between [
68
Ga]Ga-FAPI and 2-[18F]FDG PET (SUV
peak
: 7.3 vs. 5.6;
p
= 0.104).
Conclusion
Patients with AIT show higher thyroid uptake on [
68
Ga]Ga-FAPI and 2-[
18
F]FDG PET. Incidental thyroid uptake is another pitfall in the interpretation of [
68
Ga]Ga-FAPI PET and should prompt a clinical work-up.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V,SpringerOpen
Subject
