Application of 18F-FAPI-42 in preparation of product for diagnosing lung lymphangioleiomyomatosis

Abstract

The invention relates to application of 18F-FAPI-42 in preparation of a product for diagnosing lung lymphangioleiomyomatosis, and belongs to the technical field of radiography imaging agents. The invention discloses an application of < 18 > F-FAPI-42 in preparation of a product for diagnosing lung lymphangioleiomyomatosis. FAPI is a novel PET tracer agent, PET / CT of FAPI has the advantages of being low in radiation exposure, fast in-vivo metabolism and free of influences of blood glucose level changes, and patient tolerance is better. Compared with 68Ga, the radioactive isotope 18F has a longer half-life period and higher electron energy, and has more advantages in clinical use. As a novel PET / CT tracer, the 18F-FAPI-42 is remarkably superior to a traditional tracer 18F-FDG in the aspects of evaluating the condition of an LAM patient and identifying the focus of the LAM patient, including renal vascular smooth muscle lipoma, mediastinal lymphatic vessel myoma, abdominal lymphatic vessel myoma and pelvic lymphatic vessel myoma.

Description

Technical Field

[0001] The present invention relates to the technical field of contrast imaging agents, and in particular to 18 Application of F-FAPI-42 in the preparation of products for diagnosing pulmonary lymphangioleiomyomatosis. Background Art

[0002] Lymphangioleiomyomatosis (LAM) is a rare disease characterized by diffuse cystic lesions in the lungs and low-grade malignant tumors that may be accompanied by distant metastases. It includes two clinical types: sporadic LAM (S-LAM) and hereditary tuberous sclerosis complex associated lymphangioleiomyomatosis (TSC-LAM). LAM is a systemic disease involving multiple organs. The early symptoms are relatively hidden, usually manifested as progressive dyspnea, which may be accompanied by pulmonary symptoms such as pneumothorax, chylothorax, and hemoptysis. Extrapulmonary manifestations are more common in renal angiomyolipoma (AML), and may also be accompanied by meningioma and lymphangioleiomyomas (lymphangioleiomyomas, extrapulmonary lymphadenopathy and axial lymphatic cystic masses).

[0003] Currently, the diagnostic methods for LAM include lung pathological biopsy, high-resolution computed tomography (HRCT) and positron emission tomography (PET / CT).

[0004] Lung pathological biopsy is the gold standard for the diagnosis of LAM, but because pathological examination is an invasive examination and has the risk of inducing complications such as pneumothorax and hemoptysis, it has certain limitations in clinical diagnosis and treatment.

[0005] High-resolution CT is a commonly used imaging method for diagnosing pulmonary cystic changes. When HRCT finds typical diffuse cystic changes in the patient's lungs, LAM can be diagnosed if one or more of the following features appear: tuberous sclerosis complex (TSC), renal angiomyolipoma (AML), serum vascular endothelial growth factor-D ≥ 800pg / ml, chylothorax or chylous ascites, lymphangiomyoma, LAM cells or LAM cell clusters found in serous cavity effusions or lymph nodes, or histopathological confirmation of LAM (lung, retroperitoneal or pelvic tumors). Because LAM is a low-grade malignant tumor that involves multiple organs and has metastatic potential, patients are usually required to undergo a whole-body scan to assess tumor invasion. However, HRCT has certain limitations in detecting smaller lesions and lesions of the lymphatic system.

[0006] Positron emission tomography (PET), usually combined with computed tomography (CT), has become an important advanced imaging technology in oncology. With PET / CT, radioactive tracers are injected into the blood. Due to the specific cell biological characteristics of the tumor, the radioactive tracers are enriched, thus accurately locating the tumor and helping to accurately determine the metastasis of the tumor. 18 F-deoxyglucose ( 18 F-FDG) is a commonly used radioactive tracer for injection. 18 F-FDG was used to evaluate LAM, and neither LAM nor AMLs showed positive results on FDG-PET scans.

[0007] Cancer-associated fibroblasts (CAFs) are the main components of the matrix surrounding epithelial cancer cells and are key factors in cancer progression. They can produce fibroblast activation protein (FAP). FAP-positive CAFs play an important role in tumor progression and metastasis. FAP is expressed in wound healing, fibrosis, and many malignant tumor stroma, and FAP is lowly expressed in normal adult tissues. Quinoline-based fibroblast activation protein inhibitors (FAPIs) can specifically bind to FAP-related enzyme domains. FAPI is a new type of PET tracer. PET / CT with FAPI has the characteristics of low radiation exposure, rapid metabolism in the body, and no influence of changes in blood sugar levels, and patients have better tolerance. FAPI can bind to the type II transmembrane serine protease FAP expressed by CAFs and has been used to evaluate a variety of tumors and interstitial lung diseases.

[0008] However, CAFs have significant heterogeneity and various subpopulations lack clear biomarkers, so the precise cellular origin of CAFs remains unclear, and not all tumors are suitable for PET / CT scanning diagnosis using FAPI as a tracer. Summary of the invention

[0009] The purpose of the present invention is to overcome the deficiencies of the prior art and provide a method for better identifying disease lesions. 18 Application of F-FAPI-42 in the preparation of products for diagnosing pulmonary lymphangioleiomyomatosis.

[0010] To achieve the above object, the technical solution adopted by the present invention is:

[0011] In a first aspect, the present invention provides 18 Application of F-FAPI-42 in the preparation of products for diagnosing pulmonary lymphangioleiomyomatosis.

[0012] The present invention is used 18 F-FAPI-42 is a product for the diagnosis of pulmonary lymphangioleiomyomatosis, which is significantly superior to 18 F-FDG.

[0013] Furthermore, the product is an imaging agent.

[0014] Furthermore, the product is a PET / CT imaging agent.

[0015] Furthermore, the product includes a product for diagnosing sporadic lymphangioleiomyomatosis and / or hereditary tuberous sclerosis complex-associated pulmonary lymphangioleiomyomatosis.

[0016] Furthermore, the product is a product for identifying pulmonary lymphangioleiomyomatosis lesions.

[0017] In a specific embodiment of the present invention, the lesion includes renal angiomyolipoma.

[0018] In a specific embodiment of the present invention, the lesion includes mediastinal lymphangioleiomyomas.

[0019] In a specific embodiment of the present invention, the lesion includes abdominal lymphangiofibroid.

[0020] In a specific embodiment of the present invention, the lesion includes pelvic lymphangiofibroid.

[0021] Further, the product is based on 18 F-FAPI-42 is an imaging preparation prepared by adding an active ingredient to additives and / or carriers acceptable for preparing imaging agents.

[0022] Compared with the prior art, the present invention has the following beneficial effects:

[0023] FAPI is a new type of PET tracer. FAPI's PET / CT has the characteristics of low radiation exposure, rapid metabolism in the body, and is not affected by changes in blood sugar levels, so patients have better tolerance. 18 F compared to 68 Ga, with its longer half-life and higher electron energy, has more advantages in clinical use. 18 As a new type of PET / CT tracer, F-FAPI-42 is significantly superior to traditional tracers in evaluating the condition of LAM patients and identifying lesions in LAM patients, including renal angiomyolipoma, mediastinal lymphangiomyoma, abdominal lymphangiomyoma, and pelvic lymphangiomyoma. 18 F-FDG.

[0024] LAM nodules contain a large number of LAM-associated fibroblasts (LAFs), which are similar to CAFs and play an important role in the growth of LAM cells and the progression of the disease. 18 F-FAPI-42 and 18 There was no statistical difference in SUVmax and MTV / FTV between the two imaging agents F-FDG in evaluating pulmonary cystic lesions in LAM patients. Although similar features exist in CAFs in LAM lesions, CAFs have significant heterogeneity and various subpopulations lack clear biomarkers, so the precise cell origin of CAFs remains unclear. Combined with the experimental results of the present invention, it is believed that LAFs in LAM lesions in the lungs may not be CAFs. This characteristic can be used clinically to distinguish LAM lung cystic changes from cystic changes caused by tumors and inflammation. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 The maximum intensity projection (MIP) images of 4 typical S-LAM patients and 4 typical TSC-LAM patients are shown in Figure 2. 18 F-FAPI-42 and 18 F-FDG contrast imaging. A is a S-LAM patient 18 F-FAPI-42 contrast imaging; B is a TSC-LAM patient 18 F-FAPI-42 contrast imaging; C is a patient with S-LAM 18 F-FDG contrast imaging; D is a TSC-LAM patient 18 F-FDG contrast imaging. Black arrow: lymphangiomyoma; red arrow: renal angiomyolipoma. The numbers below the figure represent the patient numbers.

[0026] Figure 2This is a patient with TSC-LAM (No. 23) with typical renal angiomyolipoma. 18 F-FDG and 18 F-FAPI-42 imaging. A is a whole-body coronal fusion image; B is a whole-body coronal CT image; C is a whole-body coronal PET image; D is a fusion image of the lung window and the abdominal cross section; E is a lung window and abdominal CT cross-section image; F is a lung window and abdominal cross-section PET image. Red arrows: AML, white arrows: lung cystic lesions.

[0027] Figure 3 This is a 26-year-old typical S-LAM patient (No.29). 18 F-FDG and 18 F-FAPI-42 image. A is a whole-body coronal fusion image; B is a whole-body coronal CT image; C is a whole-body coronal PET image; D is a lung window and pelvic cross-section fusion image; E is a lung window and pelvic cross-section CT image; F is a lung window and pelvic cross-section PET image.

[0028] Figure 4 Visual assessment of SUVmax for lymphangioleiomyomas. DETAILED DESCRIPTION

[0029] To better illustrate the purpose, technical solutions and advantages of the present invention, the present invention will be further described below in conjunction with specific examples. Other materials, reagents, etc. used in the examples, unless otherwise specified, can be obtained from commercial sources.

[0030] 1. Research subjects: All operations performed in studies involving human participants were in accordance with the ethical standards of the Clinical Research Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University and the Chinese Clinical Trial Registry (ChiCTR2100044944), and in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later revisions. Informed consent was obtained from all individuals participating in the study. The patients included in this study were recruited at the First Affiliated Hospital of Guangzhou Medical University from May 2021 to February 2024. The inclusion criteria are as follows: (1) Patients who were newly diagnosed with S-LAM or TSC-LAM according to the 2017 American Thoracic Society and Japanese Respiratory Society Clinical Practice Guidelines; (2) Patients who had been treated with 1% or more of the 10-well plate within one month; 18 F-FAPI-42 (Fluoro-18 Fibroblast Activation Protein Inhibitor-42) and 18 F-FDG (fluorine-18 fluorodeoxyglucose) was used for PET-CT dual-nuclides examination. The exclusion criteria were as follows: (1) 18 F-FAPI-42 and 18The interval between F-FDG PET-CT was greater than one month; (2) patients who did not agree to be included in the study. A total of 37 patients were included, including 37 females (100%), with a median age of 33 years (22-45 years), 25 with S-LAM, 12 with TSC-LAM, and among the 37 patients, there were concomitant mediastinal lymphangiomyoma (10 patients), abdominal lymphangiomyoma (24 patients), pelvic lymphangiomyoma (17 patients), and renal angiomyolipoma (13 patients), see Table 1.

[0031] Table 1 Summary of patient characteristics

[0032]

[0033]

[0034] 2. Imaging agent: 18 F-FDG and 18 The radiochemical purity of F-FAPI-42 is over 95%. The final product is diluted with normal saline and filtered through a 0.22 μm Millipore filter into a sterile multi-dose syringe for aseptic processing. The final product is tested and confirmed to be sterile and non-pyrogenic for clinical use.

[0035] Example 1 PET-CT imaging and image reconstruction

[0036] All patients took 18 F-FAPI-42 and 18 F-FDG PET-CT scan. Patients fasted for at least 6 hours before PET-CT scan. 18 Before F-FDG PET-CT scanning, adjust blood sugar to less than 7.0mmol / L (blood sugar of diabetic patients should be less than 11.1mmol / L). 18 F-FAPI-42 No special preparation is required on the day of PET-CT examination (such as fasting or normal blood sugar level). Calculated based on the patient's weight 18 F-FDG and 18 The injection dose of F-FAPI-42 is 3.7MBq / kg.

[0037] Intravenous injection 18 F-FDG or 18Approximately 60 min (45–105 min) after F-FAPI-42, a PET-CT scan of the head to mid-thigh was performed. After the whole-body PET-CT scan, a thin-section CT scan of the chest was performed with breath-holding. All PET-CT scans were performed on two PET-CT scanners (uMi Panorama 35S, United Imaging Healthcare, Shanghai, China or Discovery MI; GE Healthcare, WI, USA) using the same general protocol.

[0038] The parameters of the Discovery MIPET-CT scanner were: tube voltage 120 kV, current 100 mA, and overall slice thickness 3.75 mm; thin-section chest CT tube voltage 120 kV, current 150 mA, slice thickness 1.25 mm; tube voltage 120 kV, current 150 mA, and head slice thickness 3.75 mm. The parameters of the uMi Panorama 35S PET-CT scanner were: tube voltage 120 kV; current, modulated mA; slice thickness 2.90 mm. All patients underwent whole-body CT scanning, and all acquired data were transferred to an advanced workstation (uMl, R002, United Imaging Healthcare) and reconstructed by the ordered subset expectation maximization (OSEM) algorithm (including 4 iterations, 10 subsets, and a 360*360 matrix).

[0039] Before the injection of the imaging agent, the medical staff checked the patient's standard vital parameters (such as blood pressure, heart rate and body temperature), and asked the patient to report any symptoms within 2 hours after the PET-CT scan. 18 F-FDG, 18 PET-CT scanning with F-FAPI-42 was well tolerated and had no adverse reactions. 18 F-FDG, 18 F-FAPI-42 related adverse reactions, no patient reported unusual symptoms.

[0040] Example 2 PET-CT image analysis and statistics

[0041] 1. Analysis

[0042] use 18 F-FDG and 18 The images after PET-CT scanning of F-FAPI-42 were interpreted by 2 nuclear medicine physicians with rich experience in PET-CT diagnosis, and any disagreements were resolved unanimously through consultation.

[0043] To prevent bias, the study was divided into groups (different physicians) according to the study type: Group 1 physicians 18The images of PET-CT scans performed with F-FDG were reviewed by the second group of physicians. 18 F-FAPI-42 PET-CT scan images were reviewed.

[0044] A positive lesion is defined as a radioactive uptake higher than that of the surrounding or contralateral normal tissue. A region of interest is created for each lesion to obtain the SUVmax (maximum standard uptake value) of the lesion. For lesions with negative uptake, a region of interest is also created based on the positioning of other radiological examinations. If there are more than one lesion in a single organ, only the highest SUVmax is recorded. On the images scanned by PET-CT, the area of ​​lesion tracer uptake that is visually higher than the background (mediastinal blood pool) is considered positive (where the positivity rate of pulmonary cystic lesions and renal angiomyolipoma RAML is visually assessed by CT). Record the number of focal lesions (positive lesions) and SUVmax. The present invention evaluates some common organs and sites of LAM accumulation: lung, kidney, mediastinum, retroperitoneum and pelvic lesions.

[0045] 2. Statistical processing

[0046] All statistical analyses were performed using SPSS 22.5 and Graphpad prism 9.5.0. The normality of the samples was verified by the Shapiro-Wilk test. All quantitative data were expressed as medians (interquartile ranges). Paired sample T tests and Wilcoxon rank sum tests were used for comparison. 18 F-FAPI-42 and 18 The differences in SUVmax, TBR, MTV / FTV, and TLG / TLF of F-FDG were compared using independent sample T test and Mann-Whitney U test. 18 F-FAPI-42 and 18 F-FDG were compared separately). The two-tailed P value was less than 0.05, indicating statistical significance.

[0047] 2. Experimental Results

[0048] 1. General clinical data: 37 patients with LAM were newly diagnosed according to the guidelines, all of whom were female, including 25 patients with S-LAM (67.57%), 12 patients with TSC-LAM (32.43%), and 13 patients with AML (35.14%), including 3 patients with S-LAM (23.08%) and 10 patients with TSC-LAM (76.92%). Three patients underwent allogeneic double lung transplantation, see Table 1. Figure 1 As shown, typical use 18 F-FAPI-42 and18 F-FDG PET-CT maximum intensity projection imaging. 18 In the F-FAPI-42 images, the abdomen (retroperitoneum, including the abdominal aorta and bilateral iliac arteries) and pelvic cavity have varying degrees of hypermetabolic lesions, some patients involve the mediastinum and bilateral groins, and the above lesions are 18 F-FDG( Figure 1 C and Figure 1 D) showed no obvious uptake. Among them, 4 typical TSC-LAM patients ( Figure 1 B and Figure 1 D) are accompanied by varying degrees of renal angiomyolipoma. These lipomas are 18 F-FAPI-42 imaging ( Figure 1 B) showed obvious radioactive uptake, while 18 F-FDG imaging ( Figure 1 D) shows no obvious uptake. In addition, cystic lesions in the lungs of patients with LAM 18 F-FDG( Figure 1 C and Figure 1 D) and 18 F-FAPI-42( Figure 1 A and Figure 1 B) The radioactive uptake was not obvious.

[0049] 2. Evaluation of imaging indicators of pulmonary cystic lesions

[0050] Three patients who underwent lung transplantation were excluded, and finally 34 lung images of LAM patients were collected. Two imaging agents ( 18 F-FDG and 18 There was no statistical difference in SUVmax and MTV / FTV of lung cystic lesions in patients with LAM by F-FAPI-42 [SUVmax: 2.17 (1.80-3.21) vs. SUVmax: 2.20 (1.76-2.54), P value = 0.4365; FTV: 2122 (1921-2700) vs. MTV: 2159 (1826-2520), P value = 0.2854]; for TBR and TLG / TLF, 18 F-FAPI-42 is superior to 18 F-FDG, there were statistical differences between the two [TBR: 1.71 (1.26-2.53) vs. TBR: 1.13 (0.95-1.38), P value < 0.0001; TLF: 1228 (923.2-1544) vs. TLG: 952.6 (797.4-1153), P value < 0.0001], see Table 2, all data are expressed as medians.

[0051] Table 2 Patients' lesions18 F-FDG and 18 Comparison of PET scan parameters of F-FAPI-42

[0052]

[0053]

[0054] In Table 2-4, “TBR”: target-background-ratio, target-background ratio; “MTV”: metabolic tumor volume, tumor metabolic volume; “TLG”: total lesion glycolysis, total lesion glycolysis value; “FTV”: FAPI-42-avid tumor volume, 18 F-FAPI-42 affinity tumor volume; "TLF": ​​Total lesionfibroblast activation protein expression, total lesion fibroblast activation protein expression; "Positive": positive lesions; "No. of Positive Lesions / All": number of positive lesions / all lesions.

[0055] 3. Evaluation of imaging indicators of renal angiomyolipoma (AML)

[0056] Among the 37 patients, 13 patients had AML, including 3 patients with S-LAM (23.08%) and 10 patients with TSC-LAM (76.92%). In the four semi-quantitative parameters of SUVmax, TBR, MTV / FTV and TLG / TLF, 18 F-FAPI-42 is significantly superior 18 F-FDG [SUVmax: 13.41 (11.29-18.14) vs. SUVmax: 3.8 (2.65-4.6); TBR: 10.7 (8.13-15.18) vs. TBR: 2.06 (1.63-2.58); FTV: 15.4 (3.70-199.7) vs. MTV: 12.30 (1.90-92.95); TLF: 72.34 (12.20-440.4) vs. TLG: 16.72 (2.81-109.6), P values ​​were all < 0.001]. See Table 2. Typical AML patients 18 F-FAPI-42 and 18 F-FDG PET / CT scan comparison, see Figure 2 AF. AML patients 18 The uptake of F-FAPI-42 (indicated by the red arrow) was significantly higher than18 F-FDG, the SUVmax of the former was about 11.1, and that of the latter was about 3.7. The uptake of lung cystic lesions in both groups was close to background. 18 F-FAPI-42SUVmax is 1.73, 18 The F-FDG SUVmax is 1.58.

[0057] 4. Evaluation of imaging indicators of lymphangiofibroids Among the 37 patients, lymphangiofibroids were distributed in the mediastinum in 10 patients (27.03%), the abdomen in 24 patients (64.86%), and the pelvis in 17 patients (45.95%). 18 The detection rates of F-FAPI-42 were significantly better than those of 18 F-FDG (mediastinum ratio: 100% and 29.41%; retroperitoneum ratio: 100% and 45.68%; pelvic ratio: 98.97% and 34.02%). 18 F-FAPI-42 and 18 In the comparison of F-FDG semi-quantitative indicators (SUVmax, TBR, MTV / FTV and TLG / TLF), except for MTV / FTV in the mediastinum [FTV: 1.21 (0.75-2.14) vs. MTV: 0.72 (0.63-1.48), P value = 0.0784 > 0.05], the remaining P values ​​were all < 0.001. 18 F-FAPI-42 imaging is significantly superior to 18 F-FDG. See Table 2. Typical LAM patients 18 F-FAPI-42 and 18 For comparison of F-FDG PET / CT imaging, see Figure 3 AF. 18 F-FAPI-42 showed nodular and linear hypermetabolic lesions in the abdominal aorta, bilateral iliac vessels, and bilateral inguinal regions (as indicated by arrows). 18 F-FDG has no obvious radioactive uptake in the above-mentioned areas. The SUVmax of the patient's lung cystic lesions was close to the background under both imaging agents (FAPI = 3.0, FDG = 1.6). Visual assessment of the SUVmax of lymphangioleiomyomas can be seen in Figure 4 .

[0058] 5. Comparative analysis of imaging indicators of S-LAM and TSC-LAM Among the 37 patients, 25 had S-LAM and 12 had TSC-LAM. Semi-quantitative comparative analysis of the two subgroups of lymphangioleiomyomas (mediastinum, retroperitoneum and pelvic) and AML (3 S-LAM and 10 TSC-LAM) was performed. 18F-FDG, 18 There was no significant statistical difference in the PET / CT scanning parameters of F-FAPI-42 overall, with only slight differences in a few PET semi-quantitative indicators.

[0059] 18 In terms of F-FAPI-42: only the SUVmax and TBR of mediastinal lymphangiomyoma [SUVmax: 8.12 (6.88-10.58) compared with SUVmax: 4.78 (4.02-6.51), P value < 0.05; TBR: 7.38 (6.25-9.61) compared with TBR: 3.62 (2.93-4.65), P value < 0.0001], and MTV / FTV and TLG / TLF of pelvic lymphangiomyoma [MTV / FTV: 3.70 (1.67-8.12) compared with 0.91 (0.54-1.34), P value < 0.001; TLG / TLF: 10.66 (4.86-36.77) compared with 2.94 (2.01-7.68), P value < 0.05].

[0060] 18 In terms of F-FDG: only the SUVmax of abdominal lymphangiomyoma [1.97 (1.60-2.41) compared with 1.74 (1.56-2.06), P value < 0.05], MTV / FTV and TLG / TLF of pelvic lymphangiomyoma [MTV / FTV: 2.33 (0.72-5.28) compared with 0.44 (0.23-1.07), P value < 0.001; TLG / TLF: 2.30 (0.62-6.46) compared with 0.44 (0.25-1.34), P value < 0.05], see Tables 3 and 4.

[0061] Table 3 Patients with S-LAM and TSC-LAM 18 Comparison of F-FAPI-42 PET parameters

[0062]

[0063] Table 4 Patients with S-LAM and TSC-LAM 18 Comparison of F-FDG PET parameters

[0064]

[0065]

[0066] Finally, it should be noted that the above embodiments are only used to illustrate the technical solution of the present invention rather than to limit the scope of protection of the present invention. Although the present invention has been described in detail with reference to the preferred embodiments, those skilled in the art should understand that the technical solution of the present invention can be modified or replaced by equivalents without departing from the essence and scope of the technical solution of the present invention.

Claims

1. 18 Application of F-FAPI-42 in the preparation of products for diagnosing pulmonary lymphangioleiomyomatosis.

2. The use according to claim 1, characterized in that: The product is an imaging agent.

3. The use according to claim 2, characterized in that: The product is a PET / CT imaging agent.

4. The use according to claim 1, characterized in that: The products include products for diagnosing sporadic lymphangioleiomyomatosis and / or hereditary tuberous sclerosis complex-associated pulmonary lymphangioleiomyomatosis.

5. The use according to claim 1, characterized in that: The product is a product for identifying pulmonary lymphangioleiomyomatosis lesions.

6. The use according to claim 5, characterized in that: The lesions include renal angiomyolipoma.

7. The use according to claim 5, characterized in that: The lesions include mediastinal lymphangioleiomyomas.

8. The use according to claim 5, characterized in that: The lesions include abdominal lymphangioleiomyomas.

9. The use according to claim 5, characterized in that: The lesions include pelvic lymphangiofibroids.

10. The use according to any one of claims 1 to 9, characterized in that: The product is based on 18 F-FAPI-42 is an imaging preparation prepared by adding an active ingredient to additives and / or carriers acceptable for preparing imaging agents.

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