68Ga-DOTA.SA.FAPi PET in Response Assessment After 177Lu-Microspheres Selective Intra-arterial Radionuclide Therapy for Unresectable Hepatocellular Carcinoma

Abstract

Abstract We report a case of a 48-year-old man with recurrent hepatocellular carcinoma, who underwent FDG PET for restaging and demonstrated mildly tracer-avid arterial enhancing lesion in segment III (SUVmax, 5.7). Owing to low FDG uptake, patient was planned for 68Ga-SA.FAPi PET, which demonstrated higher tracer avidity in the lesion (SUVmax, 24.4). Subsequently, patient underwent 177Lu-microsphere SIRT (2.2 GBq) in segment III. The 3- and 6-month posttherapy SA.FAPi PET demonstrated an interval decrease in tracer uptake and size of treated lesion. This case highlighted the promising role of SA.FAPi PET in patient selection for 177Lu-SIRT and subsequent response assessment.