Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China.
Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China.
Eur J Nucl Med Mol Imaging. 2021 Jan;48(1):73-86. doi: 10.1007/s00259-020-04940-6. Epub 2020 Jun 25.
This prospective study aimed to evaluate the potential usefulness of [Ga]Ga-DOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) in the oncological evaluation of patients presenting with inconclusive [F]FDG PET/CT findings.
[Ga]Ga-DOTA-FAPI-04 was performed in patients presenting with inconclusive [F]FDG PET/CT findings. Tumour uptake was quantified by the maximum standard uptake value (SUV). Histopathology or follow-up imaging served as the standard for the final diagnosis.
A total of 68 patients with inconclusive [F]FDG PET/CT findings underwent additional [Ga]Ga-DOTA-FAPI-04 PET/CT. Of them, 18 (26.5%) were for discrimination of mass lesions detected on conventional imaging, 6 (8.8%) for detection of the unknown primary site in biopsy-proven metastatic malignancy, 21 (30.9%) for the staging of cancer, and the other 23 (33.8%) for evaluation of suspected disease recurrence. Most of the primary and metastatic lesions demonstrated higher uptake of [Ga]Ga-DOTA-FAPI-04 than did [F]FDG, which resulted in favourable tumour-to-background contrast in various types of cancer. As a result, [Ga]Ga-DOTA-FAPI-04 PET/CT identified suspicious mass lesions with an accuracy of 12/18 (66.7%), detected the primary site in 4/6 patients (66.7%) with unknown malignancy, upgraded tumour staging in 7/21 patients (33.3%), and detected disease recurrence in 20/23 patients (87.0%).
In patients undergoing oncological evaluation with inconclusive [F]FDG PET/CT findings, [Ga]Ga-DOTA-FAPI-04 may have a complementary role in discriminating mass lesions on conventional imaging, locating the primary site of unknown malignancy, modifying tumour staging, and detecting suspected disease recurrence. Nevertheless, careful attention should be paid when reading the [Ga]Ga-DOTA-FAPI-04 PET/CT images in tumours complicated with inflammation.
本前瞻性研究旨在评估 [Ga]Ga-DOTA-FAPI-04 正电子发射断层扫描/计算机断层扫描（PET/CT）在 [F]FDG PET/CT 结果不确定的患者肿瘤评估中的潜在作用。
对 [F]FDG PET/CT 结果不确定的患者进行 [Ga]Ga-DOTA-FAPI-04 检查。肿瘤摄取通过最大标准摄取值（SUV）进行量化。组织病理学或随访影像学作为最终诊断的标准。
68 例 [F]FDG PET/CT 结果不确定的患者接受了额外的 [Ga]Ga-DOTA-FAPI-04 PET/CT 检查。其中，18 例（26.5%）用于鉴别常规影像检查发现的肿块病变，6 例（8.8%）用于检测经活检证实的转移性恶性肿瘤的未知原发灶，21 例（30.9%）用于癌症分期，其他 23 例（33.8%）用于评估疑似疾病复发。大多数原发性和转移性病变对 [Ga]Ga-DOTA-FAPI-04 的摄取高于 [F]FDG，这导致各种类型癌症的肿瘤与背景之间具有有利的对比度。因此，[Ga]Ga-DOTA-FAPI-04 PET/CT 准确识别了 18 例可疑肿块病变中的 12 例（66.7%），在 6 例（66.7%）未知恶性肿瘤患者中发现了原发灶，在 21 例（33.3%）肿瘤分期升级患者中发现了原发灶，在 23 例（87.0%）疑似疾病复发患者中发现了疾病复发。
在进行 [F]FDG PET/CT 结果不确定的肿瘤评估的患者中，[Ga]Ga-DOTA-FAPI-04 可能在鉴别常规影像上的肿块病变、定位未知恶性肿瘤的原发灶、修改肿瘤分期以及检测疑似疾病复发方面具有互补作用。然而，在阅读伴有炎症的肿瘤的 [Ga]Ga-DOTA-FAPI-04 PET/CT 图像时应谨慎。
