FAP-targeted [68Ga]BED003-PET compared with [18F]DOPA-PET in patients with recurrent medullary thyroid carcinoma
4 affiliations
- 1Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- 2West German Cancer Center, University Hospital Münster, Münster, Germany
- 3European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
- 4Clinic for Radiology, University Hospital Münster, Münster, Germany
Abstract
Aim: Molecular imaging of recurrent or advanced medullary thyroid carcinoma (MTC) remains clinically challenging. [18F]DOPA-PET is an established reference standard, but its sensitivity is limited and dependent on tumour burden and biomarker levels. Fibroblast activation protein (FAP)-targeted PET has emerged as a promising imaging approach across several malignancies. This study aimed to compare the detection rate and quantitative imaging characteristics of [68Ga]BED003-PET, recently known as [68Ga]OncoFAP-DOTAGA, with [18F]DOPA-PET in patients with recurrent or advanced MTC.
Methods: Eight patients with histologically proven MTC and suspected recurrence or progression based on elevated calcitonin levels underwent both [18F]DOPA-PET and an additional [68Ga]BED003-PET. All patients presented with inconclusive findings in [18F]DOPA-PET. Comparative analyses were performed on a patient- and lesion-based level. Quantitative parameters included maximum and mean standardized uptake values (SUVmax/SUVmean), metabolic tumour volume (MTV), and maximum tumour-to-background ratios (TBRmax). Potential theranostic suitability was explored based on lesional FAP uptake.
Results: The median interval between PET acquisitions was 33 days (range, 7–56 days). In total, 35 tracer-avid lesions were detected. [68Ga]BED003-PET detected significantly more lesions than [18F]DOPA-PET (34/35 [97%] vs. 16/35 [46%], P < 0.001). 15 lesions (43%) were positive on both modalities, 19 (54%) were only [68Ga]BED003-positive, and 1 (2.9%) was only [18F]DOPA-positive. Quantitative analysis demonstrated significantly higher uptake and contrast for [68Ga]BED003, including higher blood-pool TBRmax than [18F]DOPA (6.02 vs. 2.23, Bonferroni adjusted P < 0.001).
Conclusion: In this small MTC cohort, [68Ga]BED003-PET demonstrated higher lesion detection and TBRs in patients with inconsistent findings in [18F]DOPA-PET. Prospective multicenter validation is warranted.
Related
- Superior Efficacy of Besifovir in Reducing Hepatocellular Carcinoma Risk Compared to Tenofovir in Chronic Hepatitis B Patients: A Nationwide Cohort Study
- Commentary: Selpercatinib versus multi-kinase inhibitors for advanced medullary thyroid cancer: a network meta-analysis of RET-targeted therapies.
- Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma
- Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report
- Recurrent Syncope Due to Orthostatic Hypotension Following Lateral Medullary Infarction: A Case Report
BibTeX
@article{ventura2026faptargeted,
title = {{FAP-targeted [68Ga]BED003-PET compared with [18F]DOPA-PET in patients with recurrent medullary thyroid carcinoma}},
author = {David Ventura and Benjamin Noto and Philipp Backhaus and Philipp Schindler and Kambiz Rahbar and Michael Schäfers and Burkhard Riemann and Wolfgang Roll},
journal = {Frontiers in Nuclear Medicine},
year = {2026},
month = oct,
doi = {10.3389/fnume.2026.1949036},
url = {https://doi.org/10.3389/fnume.2026.1949036},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - FAP-targeted [68Ga]BED003-PET compared with [18F]DOPA-PET in patients with recurrent medullary thyroid carcinoma
AU - David Ventura
AU - Benjamin Noto
AU - Philipp Backhaus
AU - Philipp Schindler
AU - Kambiz Rahbar
AU - Michael Schäfers
AU - Burkhard Riemann
AU - Wolfgang Roll
PY - 2026
DA - 2026/10/21
JO - Frontiers in Nuclear Medicine
DO - 10.3389/fnume.2026.1949036
UR - https://doi.org/10.3389/fnume.2026.1949036
AB - Aim: Molecular imaging of recurrent or advanced medullary thyroid carcinoma (MTC) remains clinically challenging. [18F]DOPA-PET is an established reference standard, but its sensitivity is limited and dependent on tumour burden and biomarker levels. Fibroblast activation protein (FAP)-targeted PET has emerged as a promising imaging approach across several malignancies. This study aimed to compare the detection rate and quantitative imaging characteristics of [68Ga]BED003-PET, recently known as [68Ga]OncoFAP-DOTAGA, with [18F]DOPA-PET in patients with recurrent or advanced MTC. Methods: Eight patients with histologically proven MTC and suspected recurrence or progression based on elevated calcitonin levels underwent both [18F]DOPA-PET and an additional [68Ga]BED003-PET. All patients presented with inconclusive findings in [18F]DOPA-PET. Comparative analyses were performed on a patient- and lesion-based level. Quantitative parameters included maximum and mean standardized uptake values (SUVmax/SUVmean), metabolic tumour volume (MTV), and maximum tumour-to-background ratios (TBRmax). Potential theranostic suitability was explored based on lesional FAP uptake. Results: The median interval between PET acquisitions was 33 days (range, 7–56 days). In total, 35 tracer-avid lesions were detected. [68Ga]BED003-PET detected significantly more lesions than [18F]DOPA-PET (34/35 [97%] vs. 16/35 [46%], P < 0.001). 15 lesions (43%) were positive on both modalities, 19 (54%) were only [68Ga]BED003-positive, and 1 (2.9%) was only [18F]DOPA-positive. Quantitative analysis demonstrated significantly higher uptake and contrast for [68Ga]BED003, including higher blood-pool TBRmax than [18F]DOPA (6.02 vs. 2.23, Bonferroni adjusted P < 0.001). Conclusion: In this small MTC cohort, [68Ga]BED003-PET demonstrated higher lesion detection and TBRs in patients with inconsistent findings in [18F]DOPA-PET. Prospective multicenter validation is warranted.
SN - 2673-8880
ER -