Purpose

This study aimed to compare the diagnostic value of [⁶⁸Ga]Ga-DOTA-FGFR1 and [¹⁸F]FDG PET/CT in the evaluation of lung cancer patients.

Methods

A prospective study was conducted between March 2023 and July 2023. Patients with high clinical suspicion of lung cancer were recruited. Each participant underwent PET/CT scanning using [⁶⁸Ga]Ga-DOTA-FGFR1 and [¹⁸F]FDG within 6 days. Histopathology and clinical follow-up results serve as reference criteria for final diagnosis. We used a paired samples t-test or a Wilcoxon signed-rank test to compare the uptake of [⁶⁸Ga]Ga-DOTA-FGFR1 and [¹⁸F]FDG. The diagnostic performance between the two tracers was compared using the McNemar χ² test.

Results

A total of 101 participants were included (mean age 63.267 ± 9.344 [range 39–86 years]). In benign lung lesions, [⁶⁸Ga]Ga-DOTA-FGFR1 had lower TBR and SUVmax than [¹⁸F]FDG (2.924 vs. 5.705, P < 0.001;1.395 vs. 4.014, P < 0.001). The TBR of [⁶⁸Ga]Ga-DOTA-FGFR1 in benign lymph nodes was also lower than [¹⁸F]FDG (0.880 vs. 1.25, P < 0.001). [⁶⁸Ga]Ga-DOTA-FGFR1 had a higher diagnostic specificity for primary tumors than [¹⁸F]FDG (52% vs. 28%, P = 0.031). The specificity, accuracy, and PPV of [⁶⁸Ga]Ga-DOTA-FGFR1 for detecting lymph node metastasis were 82.54%, 78.66%, and 53.73%, respectively, higher than that of [¹⁸F]FDG (53.80%, P < 0.001, 63.15%, P < 0.001 and 38.35%, P = 0.003). However, its sensitivity in the diagnosis of lymph node and distant metastasis was not as good as [¹⁸F]FDG PET/CT (P < 0.001, P = 0.016, respectively). There was a significant correlation between [⁶⁸Ga]Ga-DOTA-FGFR1 uptake and FGFR1 expression (Spearman r = 0.6901, p < 0.0001).

Conclusions

[⁶⁸Ga]Ga-DOTA-FGFR1 PET/CT had higher specificity than [¹⁸F]FDG PET/CT for the detection of primary lung cancer. In addition, [⁶⁸Ga]Ga-DOTA-FGFR1 PET/CT also had higher diagnostic accuracy, specificity, and NPV for lymph node metastasis, but its diagnostic sensitivity for metastatic lesions was lower than [¹⁸F]FDG PET/CT. Therefore, [⁶⁸Ga]Ga-DOTA-FGFR1 can be used as an effective supplement to [¹⁸F]FDG to a certain extent.

中文翻译：

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[68Ga]Ga-DOTA-FGFR1 和 [18F]FDG PET/CT 在肺癌诊断中的头对头比较

 目的

本研究旨在比较 [⁶⁸Ga]Ga-DOTA-FGFR1 和 [¹⁸F]FDG PET/CT 在肺癌患者评估中的诊断价值。

 方法

2023 年 3 月至 2023 年 7 月期间进行了一项前瞻性研究。招募临床高度怀疑肺癌的患者。每个参与者在 6 天内接受了使用 [⁶⁸Ga]Ga-DOTA-FGFR1 和 [¹⁸F]FDG 的 PET/CT 扫描。组织病理学和临床随访结果可作为最终诊断的参考标准。我们使用配对样本 t 检验或 Wilcoxon 符号秩检验来比较 [⁶⁸Ga]Ga-DOTA-FGFR1 和 [¹⁸F]FDG 的摄取。使用 McNemar χ² 检验比较两种示踪剂之间的诊断性能。

 结果

共纳入 101 名参与者 （平均年龄 63.267 ± 9.344 [范围 39-86 岁]）。在良性肺病变中，[⁶⁸Ga]Ga-DOTA-FGFR1 的 TBR 和 SUVmax 低于 [¹⁸F]FDG（2.924 vs. 5.705，P < 0.001; 1.395 对 4.014，P % 3C 0.001）。良性淋巴结中 [⁶⁸Ga]Ga-DOTA-FGFR1 的 TBR 也低于 [¹⁸F]FDG （0.880 vs. 1.25，P < 0.001）。 [⁶⁸加]Ga-DOTA-FGFR1 对原发肿瘤的诊断特异性高于 [¹⁸F]FDG （52% vs. 28%，P = 0.031）。[⁶⁸Ga]Ga-DOTA-FGFR1 检测淋巴结转移的特异性、准确性和 PPV 分别为 82.54% 、 78.66% 和 53.73%，高于 [¹⁸F] FDG （53.80%，P < 0.001 、 63.15%，P < 0.001 和 38.35%，P = 0.003）。然而，其诊断淋巴结和远处转移的敏感性不如 [¹⁸F]FDG PET/CT （分别为 P < 0.001，P = 0.016）。 [⁶⁸Ga]Ga-DOTA-FGFR1 摄取与 FGFR1 表达之间存在显着相关性 （Spearman r = 0.6901，p < 0.0001）。

 结论

[⁶⁸加]Ga-DOTA-FGFR1 PET/CT 检测原发性肺癌的特异性高于 [¹⁸F]FDG PET/CT。此外，[⁶⁸Ga]Ga-DOTA-FGFR1 PET/CT 对淋巴结转移的诊断准确性、特异性和 NPV 也较高，但其对转移病灶的诊断敏感性低于 [¹⁸F]FDG PET/CT。因此，[⁶⁸Ga]Ga-DOTA-FGFR1 在一定程度上可以作为 [¹⁸F]FDG 的有效补充。