A groundbreaking study published in Scientific Reports on December 8th has revealed a potential game-changer in the early detection of breast cancer. The research, conducted by a team in China, suggests that PET/CT imaging times can be drastically reduced for women with suspected breast cancer, offering a more patient-friendly and efficient diagnostic approach.
The study focused on the use of F-18 FAPI-04 radiotracer, a molecular imaging agent based on fibroblast activation protein inhibitors (FAPI). This agent has shown promise in breast cancer diagnosis due to the high expression of fibroblast activation protein in the tumor microenvironment. However, most previous studies have centered on late imaging, performed around 60 minutes after tracer injection, which can be impractical for patients unable to tolerate such delays.
To explore the feasibility of early F-18 FAPI-04 PET/CT, the researchers recruited 40 women with suspected breast cancer (average age of 52) and performed dual-phase PET/CT scans at approximately 10 minutes (early) and 60 minutes (late) post-injection. None of the patients had received any prior treatment, and histopathological diagnoses were obtained through biopsy or surgical resection after the PET/CT imaging.
Two experienced nuclear medicine experts independently interpreted all PET/CT images, and their analysis revealed a total of 51 breast lesions. The researchers obtained maximum standard radiotracer uptake values (SUVmax) by outlining regions of interest in the images. Subsequent tissue biopsies confirmed 36 malignant breast cancers and 15 benign breast lesions.
The results demonstrated a significant difference in SUVmax between early and late imaging (p= 0.001), with F-18 FAPI-04 uptake in the breast cancer group significantly higher than in the benign breast lesion group. The cutoff values for SUVmax were 3.6 for early imaging and 4.1 for late imaging. Early imaging with SUVmax achieved the highest diagnostic performance, with an AUC of 1, and both sensitivity and specificity of 100%. Importantly, there was no significant difference in diagnostic performance between early and late imaging, according to the researchers.
The study's lead author, Dr. Zonglin Li, and colleagues, noted that early imaging is not only more patient-friendly but also has the potential to streamline clinical workflows and reduce unnecessary biopsies. They concluded that early F-18 FAPI-04 PET/CT imaging offers diagnostic accuracy comparable to late imaging while significantly reducing acquisition time, making it a promising practical alternative in clinical practice.
To further assess the clinical value of F-18 FAPI-04 PET/CT in diagnosing breast lesions, the researchers recommend future studies that include suspected breast cancer cases from multiple medical centers. They also emphasize the need for further investigations to explore the potential applications of this technique in breast disease subtyping, staging, and treatment response evaluation.
The full study can be accessed here: https://doi.org/10.1038/s41598-025-28097-0.
