<br>68Ga-DOTA-FAPI-04 与 18F-FDG PET/CT 在胸部原发性肺外肿瘤评估中的头对头比较,European Radiology

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68Ga-DOTA-FAPI-04 与 18F-FDG PET/CT 在胸部原发性肺外肿瘤评估中的头对头比较
European Radiology ( IF 4.7 ) Pub Date : 2023-09-05 , DOI: 10.1007/s00330-023-10130-3
Annan Zhang ₁ , Xiangxi Meng ₁ , Yuan Yao ₁ , Xin Zhou ₁ , Yan Zhang ₁ , Nan Li ₁

Affiliation

客观的

我们进行了一项前瞻性研究，使用¹⁸ F-氟脱氧葡萄糖 ( ¹⁸ F-FDG) 和⁶⁸ Ga-DOTA-FAPI-04（成纤维细胞激活蛋白抑制剂， ⁶⁸ Ga-FAPI）PET/CT 来诊断、区分和分期原发性肺外肿瘤胸部。

方法

54 名参与者接受¹⁸ F-FDG 和⁶⁸ Ga-FAPI PET/CT，并根据病理分为良性、中间性和恶性。通过两个独立样本t检验比较两种模式之间原发肿瘤、淋巴结和转移灶的最大标准化摄取值 (SUVmax)、肿瘤与血池比和肿瘤与肝脏比。使用单向方差分析来比较三组之间¹⁸ F-FDG 或⁶⁸ Ga-FAPI 的摄取。

结果

54 名参与者被确认有 71 个原发病灶、56 个转移淋巴结和 43 个转移病灶。 ¹⁸ F-FDG PET/CT均能有效区分恶性病变与非恶性病变，准确率达87.32%（ p < 0.001）。 ⁶⁸ Ga-FAPI PET/CT 能有效区分良性病变和非良性病变，准确率为 91.55%（ p < 0.001）。 ¹⁸ F-FDG 和⁶⁸ Ga-FAPI 检测淋巴结转移的准确率分别为 77.22% (61/79) 和 87.34% (69/79) ( p = 0.096)。转移淋巴结中⁶⁸ Ga-FAPI 的摄取显着高于非转移淋巴结 ( p < 0.001)。 ⁶⁸ Ga-FAPI PET/CT 对转移病灶的检出率显着高于¹⁸ F-FDG，分别为 100%（43/43）比 53.49%（23/43）（ p < 0.001）。与¹⁸ F-FDG PET/CT 相比， ⁶⁸ Ga-FAPI PET/CT 改变了 7.4%（4/54）参与者的治疗策略。

结论

⁶⁸ Ga-FAPI PET/CT 对原发性肺外肿瘤的诊断和鉴别诊断具有重要价值，在评估淋巴结及远处转移方面优于¹⁸ F-FDG PET/CT。

临床相关性声明

⁶⁸ Ga-FAPI PET/CT在原发性肺外胸部肿瘤中的应用价值体现在诊断、鉴别诊断以及淋巴结转移和远处转移的探查中。

关键点

• ⁶⁸ Ga-FAPI PET/CT 对于原发性肺外肿瘤的诊断、鉴别和分期很有价值。

• ⁶⁸ Ga-FAPI PET/CT在评估淋巴结和远处转移方面优于¹⁸ F-FDG PET/CT。

"点击查看英文标题和摘要"

Head to head comparison of 68Ga-DOTA-FAPI-04 vs 18F-FDG PET/CT in the evaluation of primary extrapulmonary tumors in the chest

Objective

We conducted a prospective study using ¹⁸F-flurodeoxyglucose (¹⁸F-FDG) and ⁶⁸Ga-DOTA-FAPI-04 (fibroblast-activation protein inhibitor, ⁶⁸Ga-FAPI) PET/CT to diagnose, differentiate, and stage primary extrapulmonary tumors of the thorax.

Methods

Fifty-four participants were undergoing ¹⁸F-FDG and ⁶⁸Ga-FAPI PET/CT and divided into the benign, intermediate, and malignant based on pathology. The maximum standardized uptake value (SUVmax), the tumor-to-blood pool ratio, and tumor-to-liver ratio were compared for primary tumors, lymph nodes, and metastases between the two modalities by two independent samples t tests. One-way ANOVA was used to compare the uptake of ¹⁸F-FDG or ⁶⁸Ga-FAPI among the three groups.

Results

Fifty-four participants were confirmed to have 71 primary lesions, 56 metastatic lymph nodes, and 43 metastatic lesions. ¹⁸F-FDG PET/CT could both effectively distinguish malignant lesions from non-malignant lesions, accuracies of 87.32% (p < 0.001). ⁶⁸Ga-FAPI PET/CT effectively differentiated benign lesions from the non-benign, accuracy being 91.55% (p < 0.001). The accuracies of ¹⁸F-FDG and ⁶⁸Ga-FAPI for detecting lymph node metastasis were 77.22% (61/79) and 87.34% (69/79) (p = 0.096). The uptake of ⁶⁸Ga-FAPI in metastatic lymph nodes was significantly higher than that of the nonmetastatic (p < 0.001). The detection rate of ⁶⁸Ga-FAPI PET/CT for metastatic lesions was significantly higher than that of ¹⁸F-FDG, 100% (43/43) vs. 53.49% (23/43) (p < 0.001). Compared with ¹⁸F-FDG PET/CT, ⁶⁸Ga-FAPI PET/CT changed the treatment strategy of 7.4% (4/54) participants.

Conclusion

⁶⁸Ga-FAPI PET/CT is valuable in the diagnosis and differentiation of primary extrapulmonary tumors and superior to ¹⁸F-FDG PET/CT for evaluating lymph node and distant metastasis.

Clinical relevance statement

The application of ⁶⁸Ga-FAPI PET/CT in primary extrapulmonary chest tumors is valuable, which is reflected in diagnosis, differentiation and exploration of lymph node metastasis and distant metastasis.