What question did this study set out to answer?

To determine whether quantitative parameters from baseline [18F]F-FDG and [18F]F-FAPI-04 PET/CT correlate with aggressive pathological features and survival outcomes in treatment-naive hepatocellular carcinoma.

September 25, 2026Cancer ImagingOpen Access

Dual-tracer 18FF-FDG and 18FF-FAPI-04 PET/CT for predicting tumor aggressiveness and prognosis in hepatocellular carcinoma

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Authors

YSYan ShaShanghai Medical College of Fudan University JLJiucen LiangGuangzhou Medical University Cancer Hospital JSJingjing SongGuangzhou Medical University Cancer Hospital

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Implication

Randomized trial reveals baseline dual-tracer PET/CT parameters predict tumor aggressiveness and survival in hepatocellular carcinoma, indicating potential for noninvasive risk stratification.

Key Points

To determine whether quantitative parameters from baseline [18F]F-FDG and [18F]F-FAPI-04 PET/CT correlate with aggressive pathological features and survival outcomes in treatment-naive hepatocellular carcinoma.
Conducted a prospective interventional trial (NCT05485792) from August 2022 to March 2025 enrolling N=48 treatment-naive patients with hepatocellular carcinoma (46 males, 2 females; median age 56.5 years).
Patients underwent both [18F]F-FDG and [18F]F-FAPI-04 PET/CT imaging to measure SUVmax, tumor-to-background ratio, metabolic tumor volume (MTV), total lesion glycolysis (TLG), FAPI-avid tumor volume (FTV), and total lesion FAP expression (TLF).
Correlations between imaging metrics and histopathological markers (CK19, GPC3, Ki-67, differentiation grade) were determined via Spearman correlation, and survival was assessed with Cox regression.
Higher [18F]F-FDG SUVmax occurred in CK19-positive versus CK19-negative tumors (5.4 vs. 4.1, P = 0.04), and [18F]F-FAPI-04 SUVmax was increased in GPC3-positive versus GPC3-negative lesions (10.2 vs. 5.9, P = 0.008).
High Ki-67 expression was associated with increased [18F]F-FAPI-04 SUVmax (10.4 vs. 6.1, P = 0.006), TBR (7.4 vs. 3.9, P = 0.04), and [18F]F-FDG SUVmax (7.7 vs. 4.7, P = 0.03), while poorly differentiated tumors had significantly elevated values across all PET parameters (all P < 0.05).
Multivariable analysis demonstrated that MTV and TLF independently predicted progression-free survival, whereas MTV, TLF, and treatment modality were independent predictors of overall survival.

Cite This Study

Sha et al. (2026) studied this question.

synapsesocial.com/papers/6ab60f7f406bf401c1468056 https://doi.org/10.1186/s40644-026-01131-8

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Implication

Randomized trial reveals baseline dual-tracer PET/CT parameters predict tumor aggressiveness and survival in hepatocellular carcinoma, indicating potential for noninvasive risk stratification.

Dual-tracer 18FF-FDG and 18FF-FAPI-04 PET/CT for predicting tumor aggressiveness and prognosis in hepatocellular carcinoma

Discussion

Member takes

Implication

Key Points

Cite This Study

Dual-tracer 18FF-FDG and 18FF-FAPI-04 PET/CT for predicting tumor aggressiveness and prognosis in hepatocellular carcinoma

Discussion

Member takes

Implication

Key Points

Cite This Study

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