Hypoxia leads to changes in tumor microenvironment (upregulated CAFs) with resultant aggressiveness. A key factor in the physiological response to hypoxia is hypoxia-inducible factor-1alpha (HIF-1α). [68Ga]Ga-FAPI PET imaging has been demonstrated in various cancer types. We hypothesized that [68Ga]Ga-FAPI PET may be used as an indirect tracer for mapping hypoxia by correlating the image findings to pathological analysis of HIF-1αexpression. The [68Ga]Ga-FAPI PET/CT scans of women with cancer of the cervix were reviewed and the maximum and mean standardized uptake value (SUVmax and SUVmean) and FAPI tumor volume (FAPI-TV) were documented. Correlation analysis was performed between PET-derived parameters and immunohistochemical staining as well as between PET-derived parameters and the presence of metastasis. Ten women were included. All patients demonstrated tracer uptake in the primary site or region of the primary. All patients had lymph node metastases while only six patients had distant visceral or skeletal metastases. The mean SUVmax, SUVmean, and FAPI-TV was 18.89, 6.88, and 195.66 cm3, respectively. The average FAPI-TV for patients with additional sites of metastases was higher than those without. Immunohistochemistry revealed varying intensities of HIF-1αexpression in all tested samples. There was a positive correlation between the presence of skeletal metastases and staining for HIF-1α(r=0.80;p=0.017). The presence of skeletal metastasis was correlated to the HIF-1⍺ staining (percentage distribution). Furthermore, the FAPI-TV was a better predictor of metastatic disease than the SUVmax.
缺氧导致肿瘤微环境发生变化（癌相关成纤维细胞上调），从而增强肿瘤侵袭性。缺氧诱导因子-1α是机体应对缺氧生理反应的关键因子。[68Ga]Ga-FAPI PET成像已在多种癌症类型中得到验证。我们假设通过将影像学表现与HIF-1α表达的病理分析相关联，[68Ga]Ga-FAPI PET可作为间接示踪剂用于缺氧状态成像。研究回顾了宫颈癌女性的[68Ga]Ga-FAPI PET/CT扫描，记录最大/平均标准摄取值及FAPI肿瘤体积，并分析PET参数与免疫组化染色、PET参数与转移灶之间的相关性。共纳入10例患者，所有患者原发灶均有示踪剂摄取。所有患者均存在淋巴结转移，仅6例发生远处内脏或骨转移。平均SUVmax、SUVmean和FAPI-TV分别为18.89、6.88和195.66立方厘米。伴其他部位转移者的平均FAPI-TV高于无转移者。免疫组化显示所有检测样本中HIF-1α表达强度各异，骨转移存在与HIF-1α染色强度呈正相关。骨转移情况与HIF-1α染色百分比分布相关，且FAPI-TV对转移性疾病的预测价值优于SUVmax。
肿瘤(癌症)患者之家