68Ga-OncoFAP-targeted PET/MRI for endometriosis assessment – initial results

J Brandt; P Backhaus; D Ventura; S Eltrop; P Schindler

doi:10.1055/s-0046-1817690

68Ga-OncoFAP-targeted PET/MRI for endometriosis assessment – initial results

J Brandt, P Backhaus, D Ventura, S Eltrop, P Schindler

In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren · 2026 · vol. 198(S 01) , pp. S92 · doi:10.1055/s-0046-1817690 · W7155176439

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This study investigated the feasibility of integrated 68Ga-OncoFAP-targeted PET/MRI for improved endometriosis detection by assessing tracer uptake and lesion counts in patients with and without endometriosis.

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This retrospective study evaluated the feasibility of integrated 68Ga-OncoFAP–targeted PET/MRI for endometriosis detection in nine premenopausal women with confirmed endometriosis and nine premenopausal women without known disease, using semi-quantitative assessment and modified #ENZIAN segmentation with clinical assessment or laparoscopy as the reference standard. PET/MRI identified more likely endometriotic findings than MRI alone, with 45/91 segments (49.5%) vs 17/91 segments (18.7%) flagged as likely endometriotic, and PET/CT or PET/MRI showed focal tracer uptake in 44/108 segments (40.7%) in the endometriosis group versus 14/108 (13.0%) in controls (p<0.01). The authors note an important limitation of the small sample size and that reference standards were not uniformly available for all participants. This paper is centrally about endometriosis — it tests 68Ga-OncoFAP PET/MRI to improve noninvasive detection, especially in anatomically challenging regions.

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Subscribe to RSS DOI: 10.1055/s-0046-1817690 68Ga-OncoFAP-targeted PET/MRI for endometriosis assessment – initial results Authors Zielsetzung Endometriosis is the leading cause for chronic pelvic pain and infertility in women of reproductive age. Conventional imaging methods may underestimate the extent of disease. Fibroblast activation protein (FAP) is highly expressed in remodeling endometrium and has been implicated in endometriosis lesions. This study investigates the feasibility of integrated FAP-targeted PET/MRI to improve endometriosis detection. Material und Methoden In this retrospective study, nine premenopausal women with confirmed endometriosis (test group) and nine premenopausal women without known endometriosis (reference group) underwent 68Ga-OncoFAP-directed PET/MRI or PET/CT (now distributed as 68Ga-BED003). Tracer uptake was assessed semi-quantitatively. Lesions were categorized based on a modified #ENZIAN segmentation. Clinical assessment or laparoscopy (when available) served as the reference standard. Statistical comparisons of tracer uptake and lesion counts between groups were performed using the Mann-Whitney U test. Ergebnisse In the test group, at least one endometriosis-related finding was identified in 6 of 7 patients who received PET/MRI when only MRI was evaluated, compared to all patients when combined PET/MRI was reviewed. In the test group, PET/MRI identified 45 of 91 segments (49.5%) as likely endometriotic compared with 17 of 91 segments (18.7%) with MRI alone. PET/CT and PET/MRI datasets showed focal tracer uptake in 44 of 108 segments (40.7%) in the test group, significantly higher than the 14 of 108 segments (13.0%) in the reference group (p<0.01). In patients who underwent laparoscopy, PET/MRI findings largely correlated with surgical results. Schlussfolgerungen 68Ga-OncoFAP-directed PET/MRI may improve the detection of endometriosis, particularly in anatomically challenging regions. As a adjunct to existing imaging strategies, 68Ga-OncoFAP-PET/MRI may refine noninvasive assessment and guide personalized management of endometriosis. Publication History Article published online: 22 April 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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Enzian

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endometriosis

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