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Background <p>Regarding the poor prognosis, limited efficacy of standard therapies, and scarce data on FAPI imaging in pediatric midline gliomas, we conducted this pilot study to investigate the potential role of [68Ga]Ga-FAPI-2286 PET/CT for improved diagnosis and possible theranostic applications in these high-risk tumors.</p> Objective <p>The study aims to evaluate the diagnostic efficacy and potential theranostic implications of [68Ga]Ga-FAPI-2286 PET/CT imaging in pediatric patients with midline gliomas.</p> Methods <p>This prospective small cohort study involved six pediatric patients aged 5–13 years diagnosed with midline gliomas (four diffuse intrinsic pontine gliomas [DIPGs], one midbrain, and one thalamic). Intravenous administration of [68Ga]Ga-FAPI-2286 (1.8–2.2 MBq/kg) was followed by PET/CT scan 45&#xa0;min later. Lesion uptake (SUVmax) and tumor-to-background ratios (TBR) were measured. Comparison analyses were done between DIPG vs. non-DIPG and high-grade vs. low-grade tumors.</p> Results <p>SUVmax varied widely (0.06–2.24), as did TBR (6–224). Non-DIPG tumors demonstrated higher uptake (mean SUVmax: 1.84, TBR: 184) compared to DIPG tumors (mean SUVmax: 0.34, TBR: 9), though differences were not statistically significant (SUVmax, <i>p</i> = 0.057; TBR, <i>p</i> = 0.091). Similarly, no significant differences were observed between high-grade and low-grade tumors. Tumors in the thalamus and midbrain showed generally higher uptake compared to pontine locations.</p> Conclusion <p>[68Ga]Ga-FAPI-2286 PET imaging showed limited utility in pediatric midline gliomas, particularly DIPGs, due to inherently low fibroblast activation protein (FAP) expression and possibly intact blood-brain barriers. Larger, more controlled studies are necessary to clarify the theranostic potential of FAPI PET in pediatric neuro-oncology.</p>

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[68Ga]Ga-FAPI-2286 PET imaging in pediatric midline gliomas: preliminary findings and clinical implications

  • 期刊论文

  • 发表日期：

    2025年8月25日

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  • Saeed Farzanefar,
  • Soheila Mirabedian,
  • Azade Kiumarsi,
  • Mehrshad Abbasi,
  • Neda Pak,
  • Mostafa Nazari,
  • Marzieh Ebrahimi,
  • Mostafa Farzin,
  • Zeinab Paymani

摘要

Background

Regarding the poor prognosis, limited efficacy of standard therapies, and scarce data on FAPI imaging in pediatric midline gliomas, we conducted this pilot study to investigate the potential role of [68Ga]Ga-FAPI-2286 PET/CT for improved diagnosis and possible theranostic applications in these high-risk tumors.

Objective

The study aims to evaluate the diagnostic efficacy and potential theranostic implications of [68Ga]Ga-FAPI-2286 PET/CT imaging in pediatric patients with midline gliomas.

Methods

This prospective small cohort study involved six pediatric patients aged 5–13 years diagnosed with midline gliomas (four diffuse intrinsic pontine gliomas [DIPGs], one midbrain, and one thalamic). Intravenous administration of [68Ga]Ga-FAPI-2286 (1.8–2.2 MBq/kg) was followed by PET/CT scan 45 min later. Lesion uptake (SUVmax) and tumor-to-background ratios (TBR) were measured. Comparison analyses were done between DIPG vs. non-DIPG and high-grade vs. low-grade tumors.

Results

SUVmax varied widely (0.06–2.24), as did TBR (6–224). Non-DIPG tumors demonstrated higher uptake (mean SUVmax: 1.84, TBR: 184) compared to DIPG tumors (mean SUVmax: 0.34, TBR: 9), though differences were not statistically significant (SUVmax, p = 0.057; TBR, p = 0.091). Similarly, no significant differences were observed between high-grade and low-grade tumors. Tumors in the thalamus and midbrain showed generally higher uptake compared to pontine locations.

Conclusion

[68Ga]Ga-FAPI-2286 PET imaging showed limited utility in pediatric midline gliomas, particularly DIPGs, due to inherently low fibroblast activation protein (FAP) expression and possibly intact blood-brain barriers. Larger, more controlled studies are necessary to clarify the theranostic potential of FAPI PET in pediatric neuro-oncology.