Evidence map›Paper›PMID 38575990›Full record

ArticleRadiation oncology (London, England)2024

Impact of FAPI-46/dual-tracer PET/CT imaging on radiotherapeutic management in esophageal cancer.

Simone Wegen, Karina Claus, Philipp Linde, Johannes Rosenbrock, Maike Trommer, Thomas Zander, Armin Tuchscherer, Christiane Bruns, Hans Anton Schlößer, Wolfgang Schröder and 7 more

Open access · goldAbstract read
In one paragraph

Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 11 citations in OpenAlex.

  1. Radiation oncology at a new frontier: Hotspots, challenges, and emerging advances.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2026
    Article
  2. Updated evidence on the accuracy ofQuantitative imaging in medicine and surgery · 2026
    Review
  3. Review
  4. Article
  5. Review
  6. Fibroblast Activation Protein Inhibitor (FAPI)-Based Theranostics.Pharmaceuticals (Basel, Switzerland) · 2025
    Review
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 3 institutions in 2 countries.

Simone WegenDepartment of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany. simone.wegen@uk-koeln.de.ORCID http://orcid.org/0000-0002-0361-728X
Karina ClausDepartment of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Philipp LindeDepartment of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Johannes RosenbrockDepartment of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Maike TrommerDepartment of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Thomas ZanderCenter for Integrated Oncology (CIO), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Armin TuchschererCenter for Integrated Oncology (CIO), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Christiane BrunsDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, with University Hospital Cologne, Cologne, Germany.
Hans Anton SchlößerDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, with University Hospital Cologne, Cologne, Germany.
Wolfgang SchröderDepartment of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, with University Hospital Cologne, Cologne, Germany.
Marie-Lisa EichInstitute of Pathology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Thomas FischerDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Klaus SchomäckerDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Alexander DrzezgaDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Carsten KobeDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Katrin Sabine RothDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Jasmin Josefine WeindlerDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
University of Cologne · DEUniversity Hospital Cologne · DEForschungszentrum Jülich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFibroblast activation protein (FAP) is expressed in the tumor microenvironment (TME) of various cancers. In our analysis, we describe the impact of dual-tracer imaging with Gallium-68-radiolabeled inhibitors of FAP (FAPI-46-PET/CT) and fluorodeoxy-D-glucose (FDG-PET/CT) on the radiotherapeutic management of primary esophageal cancer (EC).

methods32 patients with EC, who are scheduled for chemoradiation, received FDG and FAPI-46 PET/CT on the same day (dual-tracer protocol, 71%) or on two separate days (29%) We compared functional tumor volumes (FTVs), gross tumor volumes (GTVs) and tumor stages before and after PET-imaging. Changes in treatment were categorized as "minor" (adaption of radiation field) or "major" (change of treatment regimen). Immunohistochemistry (IHC) staining for FAP was performed in all patients with available tissue.

resultsPrimary tumor was detected in all FAPI-46/dual-tracer scans and in 30/32 (93%) of FDG scans. Compared to the initial staging CT scan, 12/32 patients (38%) were upstaged in nodal status after the combination of FDG and FAPI-46 PET scans. Two lymph node metastases were only visible in FAPI-46/dual-tracer. New distant metastasis was observed in 2/32 (6%) patients following FAPI-4 -PET/CT. Our findings led to larger RT fields ("minor change") in 5/32 patients (16%) and changed treatment regimen ("major change") in 3/32 patients after FAPI-46/dual-tracer PET/CT. GTVs were larger in FAPI-46/dual-tracer scans compared to FDG-PET/CT (mean 99.0 vs. 80.3 ml, respectively (p < 0.001)) with similar results for nuclear medical FTVs. IHC revealed heterogenous FAP-expression in all specimens (mean H-score: 36.3 (SD 24.6)) without correlation between FAP expression in IHC and FAPI tracer uptake in PET/CT.

conclusionWe report first data on the use of PET with FAPI-46 for patients with EC, who are scheduled to receive RT. Tumor uptake was high and not depending on FAP expression in TME. Further, FAPI-46/dual-tracer PET had relevant impact on management in this setting. Our data calls for prospective evaluation of FAPI-46/dual-tracer PET to improve clinical outcomes of EC.

Indexed as

Esophageal NeoplasmsQuinolinesFluorodeoxyglucose F18HumansPositron-Emission TomographyPositron Emission Tomography Computed TomographyTumor MicroenvironmentFAPI-46Fluorodeoxyglucose F18QuinolinesEsophageal cancerFAPI-46FDGPET-basedRadiotherapy planning

Identifiers

PMID38575990
PMCPMC10993448
OpenAlexW4393936118

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.