Purpose

This head-to-head comparison study aimed to compare the performance of [⁶⁸Ga]Ga-FAPI-RGD (LNC1007) and 2-[¹⁸F]FDG PET/CT in the evaluation of patients with metastatic differentiated thyroid cancer (mDTC).

Methods

Ten unexplained hyperthyroglobulinemia (UHTg) patients and 20 patients with definite metastatic lesions of thyroid cancer (DmDTC) were enrolled in the study. All patients underwent both [⁶⁸Ga]Ga-LNC1007 and 2-[¹⁸F]FDG PET/CT within 1 week. The final diagnosis was based on histopathological results and a comprehensive evaluation of laboratory tests and multimodal imaging characteristics.

Results

In patients with UHTg, [⁶⁸Ga]Ga-LNC1007 PET/CT detected more metastatic lymph nodes (LNs) (17 vs. 15, P = 0.317) and lung lesions (2 vs. 0) than 2-[¹⁸F]FDG. In patients with DmDTC, [⁶⁸Ga]Ga-LNC1007 PET/CT also detected more true positive lesions than 2-[¹⁸F]FDG (Total: 133 vs. 103, LN: 20 vs. 15, lung: 18 vs. 10, bone: 87 vs.73). [⁶⁸Ga]Ga-LNC1007 PET/CT demonstrated significantly higher SUVmax (Total: 6.30 vs. 3.84, LN: 8.28 vs. 4.82, Lung: 3.31 vs. 1.49, Bone: 5.73 vs. 3.87, all P < 0.05) and TBR (Total: 6.92 vs. 4.93, LN: 6.48 vs. 4.16, Lung: 5.16 vs. 2.57, Bone: 7.22 vs. 5.41, all P < 0.05) in true positive lesions compared to 2-[¹⁸F]FDG. Specifically, the sensitivity of [⁶⁸Ga]Ga-LNC1007 PET/CT was higher than that of 2-[¹⁸F]FDG in detecting lung and bone metastases (94.7% vs. 52.6% and 100% vs. 83.9%, all P < 0.05). [⁶⁸Ga]Ga-LNC1007 PET/CT exhibited better specificity and accuracy in diagnosing LNs (96.9% vs. 66.7% and 96.3% vs. 68.5%, all P < 0.05). However, the specificity of [⁶⁸Ga]Ga-LNC1007 for bone metastasis was inferior to 2-[¹⁸F]FDG (15.4% vs. 88.5%, P < 0.05).

Conclusion

Compared with 2-[¹⁸F]FDG, [⁶⁸Ga]Ga-LNC1007 PET/CT could detect more metastatic lesions, with higher SUVmax and TBR, in patients with mDTC. [⁶⁸Ga]Ga-LNC1007 had better accuracy in the diagnosis of LN and lung metastasis.

Trial registration ClinicalTrials.gov NCT05515783. Registered 01 May 2022.

URL of registry https://classic.clinicaltrials.gov/ct2/show/NCT05515783

中文翻译：

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[68Ga]Ga-LNC1007 与 2-[18F]FDG 在转移性分化型甲状腺癌患者评估中的疗效：一项头对头比较研究

 目的

这项头对头比较研究旨在比较 [⁶⁸Ga]Ga-FAPI-RGD （LNC1007） 和 2-[¹⁸F]FDG PET/CT 在评估转移性分化型甲状腺癌 （mDTC） 患者中的性能。

 方法

该研究纳入了 10 名不明原因的高甲状腺球蛋白血症 （UHTg） 患者和 20 名甲状腺癌 （DmDTC） 明确转移病灶患者。所有患者在 1 周内接受了 [⁶⁸Ga]Ga-LNC1007 和 2-[¹⁸F]FDG PET/CT。最终诊断基于组织病理学结果和对实验室检查和多模态影像学特征的综合评估。

 结果

在 UHTg 患者中，[⁶⁸Ga]Ga-LNC1007 PET/CT 检测到的转移性淋巴结 （LNs） （17 vs. 15，P = 0.317） 和肺部病变 （2 vs. 0） 比 2-^[18F]FDG 多。在 DmDTC 患者中，[⁶⁸Ga]Ga-LNC1007 PET/CT 也检测到比 2-[¹⁸F]FDG 更多的真阳性病灶（总计：133 对 103，LN：20 对 15，肺：18 对 10，骨骼：87 对 73）。[⁶⁸加]Ga-LNC1007 PET/CT 在真阳性病变中表现出显着更高的 SUVmax （总计： 6.30 vs. 3.84， LN： 8.28 vs. 4.82， 肺： 3.31 vs. 1.49， 骨骼： 5.73 vs. 3.87， 均 P < 0.05） 和 TBR （总计： 6.92 vs. 4.93， LN： 6.48 vs. 4.16， 肺： 5.16 vs. 2.57， 骨骼： 7.22 vs. 5.41， 所有 P < 0.05） 与 2-^[18F]FDG 相比。具体而言，[⁶⁸Ga]Ga-LNC1007 PET/CT 检测肺和骨转移的敏感性高于 2-[¹⁸F]FDG （94.7% vs. 52.6% 和 100% vs. 83.9%，均 P < 0.05）。[⁶⁸加]Ga-LNC1007 PET/CT 诊断 LNs 表现出更好的特异性和准确性 （96.9% vs. 66.7% 和 96.3% vs. 68.5%，均 P < 0.05）。然而，[⁶⁸Ga]Ga-LNC1007 对骨转移的特异性低于 2-[¹⁸F]FDG （15.4% vs. 88.5%，P < 0.05）。

 结论

与 2-[¹⁸F]FDG 相比，[⁶⁸Ga]Ga-LNC1007 PET/CT 可以检测到 mDTC 患者更多的转移病灶，具有更高的 SUVmax 和 TBR。[⁶⁸加]Ga-LNC1007 对 LN 和肺转移的诊断准确性更高。

试用注册 ClinicalTrials.gov NCT05515783。2022 年 5 月 1 日注册。

注册表 https://classic.clinicaltrials.gov/ct2/show/NCT05515783 的 URL