Clinical Scorecard: Characterization of FAPI Uptake Patterns and Metabolic-Stromal Diversity in Advanced Differentiated Thyroid Carcinoma Using 99mTc-FAPI-YQ3 SPECT/CT: A Prospective Imaging-Radiomics Study at a Single Center

At a Glance

Key Highlights

• 99mTc-FAPI-YQ3 SPECT/CT shows high detection rates for thyroid-bed and bone lesions.
• Dual-tracer phenotypes include FDG-positive/FAPI-positive and FDG-positive/FAPI-negative lesions.
• Exploratory radiomics analysis indicates high AUC values for lesion-level classification.

Guideline-Based Recommendations

Diagnosis

• Use 99mTc-FAPI-YQ3 SPECT/CT for characterizing FAPI uptake phenotypes.

Management

• Consider dual FDG-FAPI imaging for evaluating metabolic-stromal imaging heterogeneity.

Monitoring & Follow-up

• Further prospective studies with histopathologic and immunohistochemical validation are required.

Risks

• Tracer uptake should not be interpreted as direct tissue proof of FAP expression without validation.

Patient & Prescribing Data

Patients with locally advanced, recurrent, nodal metastatic, or distant metastatic DTC.

Limited therapeutic options for RAI-refractory disease.

Clinical Best Practices

• Integrate molecular imaging with tissue-based analyses for precision therapy.
• Acknowledge that imaging-derived phenotypes should be interpreted alongside broader molecular information.

Related Resources & Content

• Study on FAPI Imaging