Secondary Logo

Journal Logo

This month's editor's favorite is Serfling and colleagues “Interobserver Agreement Rates on Fibroblast Activation Protein Inhibitor–Directed Molecular Imaging and Therapy​". The investigators hypothesize that FAP inhibitor (FAPI)–directed molecular imaging may be useful in selecting patients for radiopharmaceutical therapy. Interobserver agreement rates for 4 blinded readers' interpretation of 68Ga-FAPI-4 PET/CT for radiopharmaceutical treatment was performed with in 49 randomized oncology patients. Per scan visual assessment was performed, including overall scan impression, number of organ and lymph node (LN) metastases, and number of affected organs and LN regions. A maximum of 3 target lesions, defined as largest in size or most intense, per organ compartment were identified.

To investigate potential reference tissues, quantification also included unaffected liver parenchyma and blood pool. Readers also indicated whether FAPI-directed radiopharmaceutical therapy should be considered. Interobserver agreement rates intraclass correlation coefficients (ICCs) were interpreted according to Cicchetti (with 0.4–0.59 indicating fair, and 0.6–0.74 good, agreement).

On a visual basis, the agreement rate for an overall scan impression was fair (ICC, 0.42; 95% confidence interval [CI], 0.27–0.57). The concordance rate for number of affected LN areas was also fair (ICC, 0.59; 95%CI, 0.45–0.72), whereas the number of LN metastases, number of affected organs, and number of organ metastases achieved good agreement rates (ICC, ≥0.63). In a quantitative analysis, concordance rates for LN were good (ICC, 0.70; 0.48–0.88), but only fair for organ lesions (ICC, 0.43; 0.26–0.60). In regard to background tissues, ICCs were good for unaffected liver parenchyma (0.68; 0.54–0.79) and fair for blood pool (0.43; 0.29– 0.58).When readers should decide on ERT, concordance rates were also fair (ICC, 0.59; 95% CI, 0.46–0.73).

The authors concluded that for FAPI-directed molecular imaging and therapy, a fair to good interobserver agreement rate was achieved, supporting the adoption of FAPI for clinical routine and multicenter treatment trials.

Current Issue


Prognostic Potential of Postoperative 18F-Fluorocholine PET/CT in Patients With High-Grade Glioma. Clinical Validation of FuMeGA Postoperative PET Criteria

García Vicente, Ana María; Pena Pardo, Francisco José; Amo-Salas, Mariano; More

Clinical Nuclear Medicine. 47(6):480-487, June 2022.

Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer

Kroese, Tiuri E.; Ruurda, Jelle P.; Bakker, Anne S.; More

Clinical Nuclear Medicine. 47(6):496-502, June 2022.

ACR-ACNM-ASTRO-SNMMI Practice Parameter for Lutetium-177 (Lu-177) DOTATATE Therapy

Love, Charito; Desai, Neil B.; Abraham, Tony; More

Clinical Nuclear Medicine. 47(6):503-511, June 2022.

Interobserver Agreement Rates on Fibroblast Activation Protein Inhibitor–Directed Molecular Imaging and Therapy

Serfling, Sebastian E.; Hartrampf, Philipp E.; Zhi, Yingjun; More

Clinical Nuclear Medicine. 47(6):512-516, June 2022.

Role of Dynamic Parameters of 18F-DOPA PET/CT in Pediatric Gliomas

Fiz, Francesco; Bini, Fabiano; Gabriele, Edoardo; More

Clinical Nuclear Medicine. 47(6):517-524, June 2022.

18F-FDG PET/CT May Predict Tumor Type and Risk Score in Gestational Trophoblastic Disease

Bezzi, Carolina; Monaco, Lavinia; Ghezzo, Samuele; More

Clinical Nuclear Medicine. 47(6):525-531, June 2022.



Amino Acid Uptake, Glucose Metabolism, and Neuroinflammation in John Cunningham Virus Associated Progressive Multifocal Leukoencephalopathy

Unterrainer, Marcus; Mahler, Christoph; Schumacher, Adrian-Minh; More

Clinical Nuclear Medicine. 47(6):543-544, June 2022.

First-in-Human Experience With 177Lu-DOTAGA.(SA.FAPi)2 Therapy in an Uncommon Case of Aggressive Medullary Thyroid Carcinoma Clinically Mimicking as Anaplastic Thyroid Cancer

Ballal, Sanjana; Yadav, Madhav Prasad; Moon, Euy Sung; More

Clinical Nuclear Medicine. 47(6):e444-e445, June 2022.


Show: