Evidence map›Paper›PMID 40423777›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2025

Multitracer comparison of gold standard PSMA-PET/CT with

Osama Mahmoud, Lukas Püllen, Lale Umutlu, Tibor Szarvas, Wolfgang P Fendler, Saskia Ting, Henning Reis, Henning Bayer, Ken Herrmann, Boris A Hadaschik and 2 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
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

12 authors.

Osama MahmoudDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany. osama.mahmoud@med.svu.edu.eg.ORCID 0000-0002-3634-9541
Lukas PüllenDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Lale UmutluInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
Tibor SzarvasDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Wolfgang P FendlerDepartment of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany.
Saskia TingInstitute of Pathology Nordhessen, Kassel, Germany.
Henning ReisDr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany.
Henning BayerDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Ken HerrmannDepartment of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany.
Boris A HadaschikDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Mulham Al-NaderDepartment of Urology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Christoph BerlinerDepartment of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to, evaluate the diagnostic accuracy of [⁶⁸Ga]Ga-FAPI-46 positron emission tomography (PET)/computed tomography (CT) in high-risk prostate cancer (PC) compared to [¹⁸F]PSMA / [⁶⁸Ga]Ga- PSMA- and [¹⁸F]FDG- PET/CT as well as multiparametric magnetic resonance imaging (MRI). MATERIALS AND

methodsTen patients with high-risk PC (PSA > 20 ng/mL, Gleason score > 7, or > T2c) underwent PET/CT imaging using [⁶⁸Ga]Ga-FAPI-46, [¹⁸F]F-/[⁶⁸Ga]Ga-PSMA and [¹⁸F]FDG before radical prostatectomy (RP). The maximum standardized uptake values (SUVmax) were measured for the entire prostate and individual prostate sextants. Diagnostic accuracy was assessed per patient and per segment by correlating imaging findings with final histopathologic results. Immunohistochemical analysis of PSMA and FAP expression was performed on the index tumor lesion.

resultsHistopathologic analysis confirmed pT2c and pT3 prostate adenocarcinoma in 4 (40%) and 6 (60%) patients, respectively. One patient (10%) had regional lymph node metastasis (pN1). The International Society of Urological Pathology (ISUP) grade groups (GGs) were 2 (60%), 3 (20%), and 5 (20%). Overall, 46 of 60 prostate sextants were histologically positive for PC. While PSMA expression was detected in all patients, FAP expression was observed in 5 of 9 cases (55.5%). Per-patient and per-segment analyses demonstrated that [⁶⁸Ga]Ga-FAPI-46 and [¹⁸F]F-/[⁶⁸Ga]Ga-PSMA had comparable diagnostic accuracy and outperformed [¹⁸F]FDG. The mean (SD) SUVmax of the entire prostate was highest for PSMA PET/CT at 13.1 (7), followed by FAPI at 7.6 (5.5) and FDG at 5.4 (3.5) (p = 0.015). Among patients in the FAPI subgroup, those with ISUP GG 3-5 exhibited greater FAP expression and radiotracer uptake compared to ISUP GG 2 cases. In the two high-grade patients, [⁶⁸Ga]Ga-FAPI-46 demonstrated greater tumor uptake than [¹⁸F]PSMA / [⁶⁸Ga]Ga-PSMA PET/CT. Notably, MRI demonstrated higher diagnostic accuracy and superior local staging compared to all radiotracers evaluated.

conclusionFAP expression was detected in a subset of high-risk PC patients, particularly in those with higher-grade disease. This proof-of-concept study may suggest a role for [⁶⁸Ga]Ga-FAPI-46 PET/CT in primary PC with low PSMA avidity, but further research is warranted to define its clinical application.

Indexed as

Edetic AcidFluorodeoxyglucose F18Positron Emission Tomography Computed TomographyProstatic NeoplasmsAgedAntigens, SurfaceGallium IsotopesGallium RadioisotopesGlutamate Carboxypeptidase IIHumansMaleMiddle AgedProof of Concept StudyQuinolinesRadiopharmaceuticals68Ga-FAPIAntigens, SurfaceEdetic AcidFluorodeoxyglucose F18Gallium IsotopesGallium RadioisotopesGlutamate Carboxypeptidase IIQuinolinesRadiopharmaceuticalsFibroblast activation proteinFluorodeoxyglucose F18Positron emission tomographyProstate neoplasmsProstate-specific membrane antigen

Identifiers

PMID40423777

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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.