Impact of fat intake on [18F]AIF-NOTA-FAPI-04 uptake in normal abdominal organs

Abstract:

Purpose: [18F]AlF-NOTA-FAPI-04 demonstrates significant physiological uptake in the gallbladder and biliary tract system, representing a limitation of this positron emission tomography (PET) tracer. The aim of this study was to evaluate the impact of milk consumed prior to a PET/CT scan on [18F]AlF-NOTA-FAPI-04 uptake in normal abdominal organs.

Materials and methods: A total of 86 patients who underwent [¹⁸F]AlF-NOTA-FAPI-04 PET/CT imaging took part in this single-center retrospective clinical study at the Hunan Cancer Hospital between December 2020 and August 2021. Patients were divided into two groups according to their pre-PET scan diet: treated group, who consumed 250 mL of milk 10 ± 5 min after the tracer injection, while the control group was permitted no food intake subsequent to the radiotracer administration. The mean standardized uptake value (SUV_mean) of gallbladder, liver, small intestine and pancreas were measured in ¹⁸F-FAPI and ¹⁸F-FDG PET/CT.

Results: There was a statistically significant difference in the ¹⁸F-FAPI uptake in the gallbladder between the treated group and the control group (p < 0.001). The average SUV_mean in the treated group was 2.19 ± 2.01, which was significantly lower than the average SUV_mean of 10.04 ± 9.66 in the control group. In the subgroup analysis of patients who underwent paired [¹⁸F]FDG and [¹⁸F]FAPI PET/CT scans, the ¹⁸F-FAPI uptake of liver and small intestine was significantly lower than the ¹⁸F-FDG uptake in both the treated group and the control group (p < 0.001).

Conclusion:This study suggests that milk consumption decreases physiological ¹⁸F-FAPI uptake in the gallbladder, potentially enhancing the diagnostic accuracy for gallbladder cancer.