Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Eur J Nucl Med Mol Imaging. 2021 Jun;48(6):1944-1955. doi: 10.1007/s00259-020-05146-6. Epub 2021 Jan 7.
The aim of this study was to explore the role of [Ga]Ga-DOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT), compared with F-fluorodeoxyglucose [F]-FDG PET/CT, for evaluating peritoneal carcinomatosis in patients with various types of cancer.
Patients with suspected peritoneal malignancy, who underwent both [F]-FDG and [Ga]Ga-DOTA-FAPI-04 PET/CT between October 2019 and August 2020, were retrospectively analysed. The radiotracer uptake, peritoneal cancer index (PCI) score, and diagnostic performance of [F]-FDG and [Ga]Ga-DOTA-FAPI-04 PET/CT were evaluated and compared.
Our cohort consisted of 46 patients, including 16 patients with diffuse-type peritoneal carcinomatosis, 27 with nodular-type peritoneal carcinomatosis, and 3 true-negative patients. A significant difference in standard uptake values (SUV) of lesions between [F]-FDG and [Ga]Ga-DOTA-FAPI-04 PET/CT examination was observed (median SUV: 3.48 vs. 9.82; P < 0.001), particularly in peritoneal carcinomatosis from gastric cancer (median SUV: 3.44 vs. 8.05; P = 0.001). Moreover, [Ga]Ga-DOTA-FAPI-04 PET/CT showed a higher PCI score and better sensitivity than [F]-FDG PET/CT for the detection of peritoneal carcinomatosis (6 vs. 18; P < 0.001; 72.09% vs. 97.67%; P = 0.002).
[Ga]Ga-DOTA-FAPI-04 PET/CT demonstrated superior sensitivity over [F]-FDG PET/CT for the detection of peritoneal carcinomatosis in patients with various types of cancer, particularly gastric cancer. Furthermore, the uptake of [Ga]Ga-DOTA-FAPI-04 in peritoneal carcinomatosis was significantly higher than that of [F]-FDG, demonstrating a larger extent of the lesions and yielding a higher PCI score. This could help enhance the image contrast, improve physicians' diagnostic confidence, and reduce the proportion of missed diagnoses.
本研究旨在探讨[Ga]Ga-DOTA-FAPI-04 正电子发射断层扫描/计算机断层扫描（PET/CT）与 F-氟脱氧葡萄糖[F]-FDG PET/CT 相比，在评估各种类型癌症患者腹膜癌病中的作用。
回顾性分析 2019 年 10 月至 2020 年 8 月期间同时接受[F]-FDG 和[Ga]Ga-DOTA-FAPI-04 PET/CT 检查的疑似腹膜恶性肿瘤患者。评估并比较了放射性示踪剂摄取、腹膜癌指数（PCI）评分以及[F]-FDG 和[Ga]Ga-DOTA-FAPI-04 PET/CT 的诊断性能。
我们的队列包括 46 名患者，其中弥漫型腹膜癌病 16 例，结节型腹膜癌病 27 例，3 例为真阴性患者。[F]-FDG 和[Ga]Ga-DOTA-FAPI-04 PET/CT 检查中病变的标准摄取值（SUV）存在显著差异（中位数 SUV：3.48 比 9.82；P<0.001），尤其是胃癌腹膜癌病（中位数 SUV：3.44 比 8.05；P=0.001）。此外，[Ga]Ga-DOTA-FAPI-04 PET/CT 对腹膜癌病的检测显示出比[F]-FDG PET/CT 更高的 PCI 评分和更好的敏感性（6 比 18；P<0.001；72.09%比 97.67%；P=0.002）。
[Ga]Ga-DOTA-FAPI-04 PET/CT 对各种类型癌症患者腹膜癌病的检测敏感性优于[F]-FDG PET/CT，尤其是胃癌。此外，[Ga]Ga-DOTA-FAPI-04 在腹膜癌病中的摄取量明显高于[F]-FDG，表明病变范围更大，PCI 评分更高。这有助于增强图像对比度，提高医生的诊断信心，并减少漏诊的比例。
