Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Eur J Nucl Med Mol Imaging. 2022 Jul;49(8):2889-2901. doi: 10.1007/s00259-022-05700-4. Epub 2022 Feb 3.
We aimed to evaluate the value of [ Ga]Ga-DOTA-FAPI-04 PET/CT for the diagnosis of recurrent soft tissue sarcoma (STS), compared with [F]FDG PET/CT.
A total of 45 patients (21 females and 24 males; median age, 46 years; range, 18-71 years) with 13 subtypes of STS underwent [F]FDG and [ Ga]Ga-DOTA-FAPI-04 PET/CT examination within 1 week for assessment local relapse or distant metastasis. Positive lesions on PET/CT images were verified by biopsy or 3-month follow-up. Wilcoxon matched-pairs signed-rank test was used to compare the semiquantitative values (SUV and TBR) of [F]FDG and [ Ga]Ga-DOTA-FAPI-04 in tumor lesions, and McNemar test was applied to test for differences of both tracers.
Among the 45 patients, 282 local relapses and distant metastases were identified. Compared to [F]FDG, [ Ga]Ga-DOTA-FAPI-04 PET/CT detected more lesions (275 vs. 186) and outperformed in sensitivity, specificity, PPV, NPV, and accuracy for the diagnosis of recurrent lesions (P < 0.001). [ Ga]Ga-DOTA-FAPI-04 demonstrated significantly higher values of SUV and TBR than [F]FDG PET/CT in liposarcoma (P = 0.011 and P < 0.001, respectively), malignant solitary fibrous tumor (MSFT) (P < 0.001 and P < 0.001, respectively), and interdigitating dendritic cell sarcoma (IDCS) (P < 0.001and P < 0.001, respectively). While mean SUV and TBR presented favorable uptake of [F]FDG over [ Ga]Ga-DOTA-FAPI-04 in undifferentiated pleomorphic sarcoma (UPS) (P = 0.003 and P < 0.001, respectively) and rhabdomyosarcoma (RMS) (P < 0.001 and P < 0.001, respectively).
[ Ga]Ga-DOTA-FAPI-04 PET/CT is a promising new imaging modality for recurrent surveillance of STS, and compares favorably with [F]FDG for identifying recurrent lesions of liposarcoma, MSFT, and IDCS.
我们旨在评估 [^68^Ga]Ga-DOTA-FAPI-04 PET/CT 对复发性软组织肉瘤（STS）的诊断价值，并与 [^18^F]FDG PET/CT 进行比较。
共 45 例 STS 患者（21 名女性和 24 名男性；中位年龄 46 岁；年龄范围 18-71 岁）接受了 [^18^F]FDG 和 [^68^Ga]Ga-DOTA-FAPI-04 PET/CT 检查，用于评估局部复发或远处转移。PET/CT 图像上的阳性病变通过活检或 3 个月的随访进行证实。采用 Wilcoxon 配对符号秩检验比较肿瘤病变中 [^18^F]FDG 和 [^68^Ga]Ga-DOTA-FAPI-04 的半定量值（SUV 和 TBR），采用 McNemar 检验比较两种示踪剂的差异。
在 45 例患者中，共发现 282 处局部复发和远处转移。与 [^18^F]FDG 相比，[^68^Ga]Ga-DOTA-FAPI-04 PET/CT 检测到更多的病变（275 处 vs. 186 处），并且在诊断复发性病变的敏感性、特异性、PPV、NPV 和准确性方面表现更优（P < 0.001）。[^68^Ga]Ga-DOTA-FAPI-04 在脂肪肉瘤（P = 0.011 和 P < 0.001）、恶性孤立性纤维性肿瘤（MSFT）（P < 0.001 和 P < 0.001）和树突状细胞肉瘤（IDCS）（P < 0.001 和 P < 0.001）中 SUV 和 TBR 值均显著高于 [^18^F]FDG PET/CT。然而，在未分化多形性肉瘤（UPS）（P = 0.003 和 P < 0.001）和横纹肌肉瘤（RMS）（P < 0.001 和 P < 0.001）中，[^18^F]FDG 对 SUV 和 TBR 的摄取表现出较好的摄取。
[^68^Ga]Ga-DOTA-FAPI-04 PET/CT 是一种很有前途的 STS 复发监测新影像学方法，在识别脂肪肉瘤、MSFT 和 IDCS 的复发性病变方面优于 [^18^F]FDG。
