Comparison of 68Ga-FAPI and 18F-DOPA PET/CT in patients with medullary thyroid cancer - Report - MDSpire

Comparison of 68Ga-FAPI and 18F-DOPA PET/CT in patients with medullary thyroid cancer

  • By

  • Daniel A. Hescheler

  • Dogan Atiyat

  • Kerstin Lorenz

  • Alexander Heinzel

  • Philipp Reschke

  • Frankis G. Almaguel

  • Manuela Petersen

  • Elisabeth Eppard

  • Joanna Wybranska

  • Jan Wuestemann

  • Michael C. Kreissl

  • June 24, 2026

  • 0 min

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Clinical Report: Evaluation of 68Ga-FAPI versus 18F-DOPA PET/CT in MTC

Overview

This study compares the diagnostic accuracy of 68Ga-FAPI and 18F-DOPA PET/CT in detecting metastases in medullary thyroid carcinoma (MTC). Results indicate differences in lesion detection rates and tumor-to-background ratios.

Background

Medullary thyroid carcinoma (MTC) is a rare malignancy that requires accurate staging for effective management. Traditional imaging methods, including 18F-DOPA PET/CT, have limitations in sensitivity and specificity. The application of 68Ga-FAPI PET/CT in MTC has not been extensively investigated.

Data Highlights

Metastasis Type68Ga-FAPI TP Rate18F-DOPA TP Rate68Ga-FAPI TBR18F-DOPA TBR
Lymph Nodes100% (8/8)50% (4/8)10.96.9
Lungs85.7% (12/14)42.9% (6/14)6.13.6
Liver100% (22/22)23% (5/22)24.12.7

Key Findings

  • 68Ga-FAPI demonstrated a 100% true-positive rate for lymph node metastases compared to 50% for 18F-DOPA.
  • For lung metastases, 68Ga-FAPI had an 85.7% true-positive rate versus 42.9% for 18F-DOPA.
  • In liver metastases, 68Ga-FAPI achieved a 100% true-positive rate, while 18F-DOPA only reached 23%.
  • 68Ga-FAPI provided higher tumor-to-background ratios (TBR) across all metastasis types compared to 18F-DOPA.

Clinical Implications

Further validation in larger studies is necessary to confirm these results.

Conclusion

68Ga-FAPI PET/CT may enhance the detection of metastases in medullary thyroid carcinoma compared to 18F-DOPA. Larger prospective studies are needed to validate these findings.

Related Resources & Content

  1. European Radiology, 2022 -- Role of Dual-Tracer PET/CT with [68Ga]FAPI-04 and [18F]FDG in the Initial Assessment of Gastric Cancer
  2. European Radiology, 2024 -- Assessing the Diagnostic Accuracy of [18F]ALF-NOTA-FAPI-04 PET/CT in Gastric Cancer Compared to [18F]FDG PET/CT: A Comparative Analysis
  3. The ASCO Post, 2024 -- FAPI PET/CT May Improve Staging in Newly Diagnosed Breast Cancer
  4. Medullary Thyroid Carcinoma: Imaging - PubMed
  5. EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma
  6. The ASCO Post — Molecular Imaging May Improve the Staging and Treatment of Pancreatic Ductal Adenocarcinoma
  7. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Thyroid Carcinoma
  8. The role of [18F]F-DOPA PET/CT in diagnostic and prognostic assessment of medullary thyroid cancer: a 15-year experience with 109 patients
  9. Medullary Thyroid Carcinoma: Imaging - PubMed
  10. EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma
  11. The value of 18F-FDG PET/CT and 18F-DOPA PET/CT in determining the initial surgical strategy of patients with medullary thyroid cancer : Preoperative PET/CT imaging for medullary thyroid cancer - PubMed
  12. CTR-FAPI PET enables precision management of medullary thyroid carcinoma | Cancer Discovery | American Association for Cancer Research
  13. Covalent FAPI Imaging–Guided Precision Surgery in Patients with Medullary Thyroid Carcinoma: A Phase II Clinical Trial - PMC
  14. Frontiers | Comparison of ⁶⁸Ga-FAPI and ¹⁸F-DOPA PET/CT in patients with medullary thyroid cancer

Original Source(s)

Comparison of 68Ga-FAPI and 18F-DOPA PET/CT in patients with medullary thyroid cancer

  • by Daniel A. Hescheler, Dogan Atiyat, Kerstin Lorenz, Alexander Heinzel, Philipp Reschke, Frankis G. Almaguel, Manuela Petersen, Elisabeth Eppard, Joanna Wybranska, Jan Wuestemann, Michael C. Kreissl

  • June 24, 2026

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