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Characterizing Histiocytosis With 68Ga-FAPI PET/CT

Not Applicable
Not yet recruiting
Conditions
Histiocytosis
Interventions
Diagnostic Test: 68Ga-FAPI
Diagnostic Test: 18F-FDG
Registration Number
NCT05803629
Lead Sponsor
Peking Union Medical College Hospital
Brief Summary

Histiocytic disorders are rare diseases that are characterized by tissue infiltration of histiocytes (dendritic cells) and other inflammatory white blood cells.68Ga-FAPI has been developed as a tumor-targeting agent as fibroblast activation protein is overexpressed in cancer-associated fibroblasts and it might be a pan-tumor PET agent.Recent discoveries have shown that inflammation and fibrosis secondary to mutated histiocytes, rather than a proliferative cell mechanism, result in manifestation of the disease.Thus, the investigators aim to carry out this prospective study to investigate the role of 68Ga-FAPI PET/CT in the diagnosis, therapy response assessment and follow-up of histiocytosis.

Detailed Description

Histiocytic disorders are rare diseases that are characterized by tissue infiltration of histiocytes (dendritic cells) and other inflammatory white blood cells. The archaic term "histiocyte" refers to large white blood cells resident in tissues and includes Langerhans cells, monocytes/macrophages, and dermal/interstitial dendritic cells. The Histiocytic Society classification divides histiocytic disorders into five categories, based on clinical, histologic, immunophenotypic, and molecular features. They are langerhans (L) group, cutaneous and mucocutaneous (C) group, Rosai-Dorfman disease (R) group, malignant histiocytosis (M) group and hemophagocytic lymphohistiocytosis (H) group. Langerhans cell histiocytosis is the most common histiocytic disorder. Less common types include Erdheim-Chester disease, Rosai-Dorfman disease, adult and juvenile xanthogranuloma. Diagnosis, which relies on a multidisciplinary approach, is challenging and often delayed because clinical findings are nonspecific and may mimic malignant processes at radiologic evaluation. Compared with conventional imaging, PET/CT allows detection of the increased metabolic activity in histiocytes and provides a comprehensive whole-body evaluation of their potential involvement with multiple organ systems and allows monitoring of therapeutic response. However, one drawback is that the uptake of FDG is nonspecific because histiocytic lesions may mimic neoplastic processes at PET/CT. And the physiological FDG metabolism in brain, liver and gastrointestinal tract, et al. hampers the detection rate of lesions located in these organs.68Ga-FAPI has been developed as a tumor-targeting agent as fibroblast activation protein is overexpressed in cancer-associated fibroblasts and it might be a pan-tumor PET agent. Although the pathogenesis of histiocytosis may be attributable to mutations in the oncogenic driver, recent discoveries have shown that inflammation and fibrosis secondary to mutated histiocytes, rather than a proliferative cell mechanism, result in manifestation of the disease. Considering 68Ga-FAPI revealing cancer-associated fibroblasts, the investigators aim to carry out this prospective study to investigate the role of 68Ga-FAPI PET/CT in the diagnosis, therapy response assessment and follow-up of histiocytosis.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • suspected or confirmed untreated histiocytosis patients
  • 18F-FDG PET/CT within two weeks;
  • signed written consent.
Exclusion Criteria
  • pregnancy;
  • breastfeeding;
  • known allergy against FAPI

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
68Ga-FAPI ,PET/CT68Ga-FAPIInject 68Ga-FAPI and then perform PET/CT scan.
68Ga-FAPI ,PET/CT18F-FDGInject 68Ga-FAPI and then perform PET/CT scan.
Primary Outcome Measures
NameTimeMethod
Diagnostic valuethrough study completion, an average of 1 year

Sensitivity and Specificity of 68Ga-FAPI PET/CT for histiocytosis in comparison with 18F-FDG PET/CT

Secondary Outcome Measures
NameTimeMethod
FAPI expression and SUVthrough study completion, an average of 1 year

Correlation between FAPI expression and SUV in PET

Disease burden assessementthrough study completion, an average of 1 year

Correlation between Total Lesion Glycolysis (TLG) of histiocytosis lesions assessed on 68Ga-FAPI PET/CT and clinical parameters for histiocytosis

Metabolic parametersthrough study completion, an average of 1 year

Total Lesion Glycolysis (TLG) of histiocytosis lesions are measured on 68Ga-FAPI PET/CT.

therapy responsethrough study completion, an average of 1 year

Decrease of Total Lesion Glycolysis (TLG) on 68Ga-FAPI PET/CT after therapy

Trial Locations

Locations (1)

Department of Nuclear Medicine, Peking Union Medical College Hopital, Chinese Academy of Medical Science

🇨🇳

Beijing, China

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