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Imaging of desmoplastic small round-cell tumor on 68Ga-FAPI PET/CT
Valor diagnóstico de la imagen PET/TC con [68Ga]Ga-FAPI en el tumor de células redondas pequeñas desmoplásticas
Yuhong Liua, Huipan Liub,c,d,
, Zibei Wanb,c,d, Yue Chenb,c,d, Jianwen Zhanga,
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Corresponding author
a Department of Oncology, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
b Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
c Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
d Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
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En las imágenes axiales (B), coronales (C) y sagitales (D) de la PET/TC, se observaron masas de partes blandas irregulares con una captación intensa (SUVmax 7,9) en la cavidad pélvica (flechas sólidas). También se observó un engrosamiento difuso del peritoneo (flechas punteadas) con un aumento en la captación del trazador (SUVmax 6,8) (fila superior: PET; fila media: TC; fila inferior: PET/TC).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Y. Liu, H. Liu, Z. Wan, Y. Chen, J. Zhang" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Y." "apellidos" => "Liu" ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Liu" ] 2 => array:2 [ "nombre" => "Z." "apellidos" => "Wan" ] 3 => array:2 [ "nombre" => "Y." "apellidos" => "Chen" ] 4 => array:2 [ "nombre" => "J." 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"aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:4 [ "nombre" => "Jianwen" "apellidos" => "Zhang" "email" => array:1 [ 0 => "zhangjianwen66@126.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Oncology, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan Province, China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan Province, China" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Southwest Medical University, Luzhou, 646000, Sichuan Province, China" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan Province, China" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding authors." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valor diagnóstico de la imagen PET/TC con [<span class="elsevierStyleSup">68</span>Ga]Ga-FAPI en el tumor de células redondas pequeñas desmoplásticas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1884 "Ancho" => 3610 "Tamanyo" => 529613 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The MIP (A) image of <span class="elsevierStyleSup">68</span>Ga-FAPI PET/CT revealed increased FAPI uptake in the pelvic cavity (solid arrow) and lower abdomen (dotted arrows). On the axial (B), coronal (C), and sagittal (D) images of PET/CT images showed the irregular soft tissue masses with intense uptake (SUVmax, 7.9) in the pelvic cavity (solid arrows). Diffuse thickening of the peritoneum (dotted arrows) with increased tracer uptake (SUVmax, 6.8) was also observed (upper row: PET; middle row: CT; lower row: fused PET/CT).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 19-year-old man presented with abdominal pain for 6 months. Abdominal enhanced CT showed extensive irregular soft tissue masses in the pelvic cavity and thickening of the peritoneum, with inhomogeneous enhancement. Abdominal puncture biopsy revealed desmoplastic small round-cell tumor (DSRCT). Subsequently, four cycles of chemotherapy (cisplatin plus etoposide) were performed. However, the patient reported experiencing discomfort including thrombocytopenia, leukopenia, nausea, and vomiting after chemotherapy. Thus, chemotherapy was stopped. Then, the patient was admitted to our hospital. With the patient's informed consent, he was included in the clinical trial of <span class="elsevierStyleSup">68</span>Ga-FAPI-04 PET/CT in tumors. The MIP image of <span class="elsevierStyleSup">68</span>Ga-FAPI PET/CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) revealed increased FAPI uptake in the pelvic cavity (solid arrow) and lower abdomen (dotted arrows), which showed the irregular soft tissue masses with intense uptake (SUVmax, 7.9) in the pelvic cavity (solid arrows). Diffuse thickening of the peritoneum (dotted arrows) with increased tracer uptake (SUVmax, 6.8) was also observed. The PET/CT finding were consistent with DSRCT. Subsequently, the patient received <span class="elsevierStyleSup">177</span>Lu-FAP2286 therapy (dose of 7.4 GBq, first cycle) with stable disease. Further follow-up is still under observation.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">DSRCT is a rare, highly aggressive malignancy, that predominantly occurs in adolescents, and it often presents as multiple uneven density masses in the abdominal and pelvic cavities, involving the peritoneum and abdominal lymph nodes, lacking a definite organ origin.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Thus, DSRCT is difficult to distinguish from other abdominal tumors. Furthermore, previous studies have preliminarily shown that <span class="elsevierStyleSup">18</span>F-FDG PET/CT is essential for the diagnosis, staging, and management of DSRCT.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, sometimes it cannot distinguish between certain infections and malignant tumors, and due to the physiological uptake of FDG in the gastrointestinal tract, this may limit its use in certain situations. <span class="elsevierStyleSup">68</span>Ga-FAPI is based on the molecular targeting of the FAP, known to be highly expressed in the major cell population in tumor stroma,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> which might be considered as the preferred imaging modality for monitoring DSRCT patients. Meanwhile, our case suggests that <span class="elsevierStyleSup">68</span>Ga-FAPI PET/CT may also be helpful in guiding the precise therapy of <span class="elsevierStyleSup">177</span>Lu-FAP2286 in DSRCT.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical statement</span><p id="par0015" class="elsevierStylePara elsevierViewall">All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">Written informed consent for publication of this report was obtained from the patient.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical statement" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Informed consent" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1884 "Ancho" => 3610 "Tamanyo" => 529613 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The MIP (A) image of <span class="elsevierStyleSup">68</span>Ga-FAPI PET/CT revealed increased FAPI uptake in the pelvic cavity (solid arrow) and lower abdomen (dotted arrows). On the axial (B), coronal (C), and sagittal (D) images of PET/CT images showed the irregular soft tissue masses with intense uptake (SUVmax, 7.9) in the pelvic cavity (solid arrows). Diffuse thickening of the peritoneum (dotted arrows) with increased tracer uptake (SUVmax, 6.8) was also observed (upper row: PET; middle row: CT; lower row: fused PET/CT).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoplastic small round cell tumor with ovarian involvement on [(18)F]-FDG PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z. Zheng" 1 => "P. Hu" 2 => "Y. He" 3 => "H. Shi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remnie.2023.09.002" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol (Engl Ed)" "fecha" => "2024" "volumen" => "43" "paginaInicial" => "55" "paginaFinal" => "56" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoplastic small round cell tumor of bone revealed by (18)F-FDG PET/CT: a case report with literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Zhang" 1 => "S. Dai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-024-04654-y" "Revista" => array:2 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2024" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PET/CT FAPI: procedure and evidence review in oncology" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Oncology Task Force of Spanish Nuclear M" "etal" => true "autores" => array:5 [ 0 => "A.P. Caresia" 1 => "J. Jo Rosales" 2 => "M. Rodriguez Fraile" 3 => "A. Arcay Ozturk" 4 => "C. Artigas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remnie.2024.02.005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol (Engl Ed)" "fecha" => "2024" "volumen" => "43" "paginaInicial" => "130" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/38331248" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004300000003/v3_202408071237/S2253808924000223/v3_202408071237/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004300000003/v3_202408071237/S2253808924000223/v3_202408071237/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000223?idApp=UINPBA00004N" ]
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