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PURPOSE: This study aimed to compare the diagnostic efficacy of 68 GaGa-DOTA.SA.FAPi and 18 FF-FDG PET/CT for detecting primary and metastatic lesions in sarcoma patients. MATERIALS AND METHODS: The analysis included both patient-based and lesion-based comparisons of PET/CT scans in individuals with histologically confirmed sarcoma. RESULTS: A total of 23 sarcoma patients (mean age 43.0 ± 16.5 years; range: 21-76 years) underwent both 18 FF-FDG and 68 GaGa-DOTA.SA.FAPi PET/CT scans. Histological distribution included 30% synovial sarcoma, 13% liposarcoma, and 21.7% leiomyosarcoma, with 70% of patients presenting with distant metastases. Detection rates for primary tumors were similar between 68 GaGa-DOTA.SA.FAPi and 18 FF-FDG PET/CT (85.7% vs 100%, P = 0.149). Lymph node detection rates were also comparable (80% vs 100%, P = 0.146). Lesion-based analysis revealed that 68 GaGa-DOTA.SA.FAPi detected 220 lesions (83% efficiency) compared with 249 lesions (94% efficiency) for 18 FF-FDG ( P < 0.0001). Notably, 68 GaGa-DOTA.SA.FAPi demonstrated superior detection of liver (54 vs 38 lesions, P < 0.0001) and bone metastases (125 vs 102 lesions, P < 0.0001). CONCLUSIONS: Our study shows that although 18 FF-FDG PET/CT offers superior overall lesion detection efficiency, 68 GaGa-DOTA.SA.FAPi PET/CT excels in identifying specific metastatic sites, particularly in bone and liver. These findings highlight the complementary roles of both imaging modalities in sarcoma evaluation.
Sakir et al. (Wed,) studied this question.