Department of Nuclear Medicine, Gaziantep University, Gaziantep 27310, Turkey.
Department of Oncology, Medical Park Private Hospital, Gaziantep 27090, Turkey.
Tomography. 2022 Feb 1;8(1):293-302. doi: 10.3390/tomography8010024.
In this study, we aimed to compare [68Ga]FAPI PET/CT and [18F]FDG PET/CT imaging to detect lesions in multiple myeloma.
A total of 14 patients with multiple myeloma who underwent [68Ga]FAPI PET/CT and [18F]FDG PET/CT imaging were included in this retrospective study. SUV values of [68Ga]FAPI and [18F]FDG were compared according to lesion locations. Also, lesion localization ability of both imaging methods was compared on the patient basis.
In 4 of 14 patients, [68Ga]FAPI PET/CT and [18F]FDG PET/CT have not detected any bone lesions. In 8 of the remaining 10 patients [18F]FDG PET/CT detected bone lesions but in this group, 6 patients showed more higher SUV values than [18F]FDG PET/CT in [68Ga]FAPI PET/CT.In contrast, 2 of 8 patients showed more higher SUV values than [68Ga]FAPI PET/CT in [18F]FDG PET/CT. Moreover, [68Ga]FAPI PET/CT detected bone lesions in two patients, which werenot detected by [18F]FDG PET/CT. Also, in five patients, [68Ga]FAPI PET/CT showed more bone lesions in comparison with[18F]FDG PET/CT. Only one patient, [18F]FDG PET/CT showed more bone lesions. Three extramedullary involvements were observed in the following locations: lung, presacral lymph node, and soft tissue mass lateral to the right maxillary sinus. Among these involvements, higher SUV values were observed in the lung and presacral lymph node with [68Ga]FAPI compared to [18F]FDG. However, the soft tissue mass showed a higher SUV value in [18F]FDG than [68Ga]FAPI.
No significant superiority was observed in [68Ga]FAPI PET/CT over [18F]FDG PET/CT in patients with MM. However, [68Ga]FAPI PET/CT can be utilized as a complementary imaging method to [18F]FDG PET/CT in some settings, especially in low-[18F]FDG affinity and inconclusive cases. Considering the favorable aspects of [68Ga]FAPI PET/CT in MM, such as low background activity, absence of non-specific bone marrow, and physiological brain involvement, further studies with a larger sample size should be conducted.
本研究旨在比较[68Ga]FAPI PET/CT 和 [18F]FDG PET/CT 成像在多发性骨髓瘤中的病灶检测能力。
本回顾性研究共纳入 14 例多发性骨髓瘤患者，这些患者均接受了[68Ga]FAPI PET/CT 和 [18F]FDG PET/CT 成像。根据病灶位置比较了[68Ga]FAPI 和 [18F]FDG 的 SUV 值。此外，还基于患者比较了两种成像方法的病灶定位能力。
在 14 例患者中，有 4 例[68Ga]FAPI PET/CT 和 [18F]FDG PET/CT 均未检测到任何骨病灶。在其余 10 例患者中，[18F]FDG PET/CT 检测到了骨病灶，但在该组中，有 6 例患者的[68Ga]FAPI PET/CT 的 SUV 值高于 [18F]FDG PET/CT，而在 8 例患者中有 2 例患者的[18F]FDG PET/CT 的 SUV 值高于 [68Ga]FAPI PET/CT。此外，[68Ga]FAPI PET/CT 还在 2 例[18F]FDG PET/CT 未检测到骨病灶的患者中检测到了骨病灶。此外，在 5 例患者中，[68Ga]FAPI PET/CT 比 [18F]FDG PET/CT 显示出更多的骨病灶。只有 1 例患者[18F]FDG PET/CT 显示出更多的骨病灶。在以下部位观察到 3 例骨髓外受累：肺、骶前淋巴结和右侧上颌窦外侧软组织肿块。在这些受累部位中，与 [18F]FDG 相比，[68Ga]FAPI 在肺部和骶前淋巴结中的 SUV 值更高。然而，软组织肿块在 [18F]FDG 中的 SUV 值高于 [68Ga]FAPI。
在 MM 患者中，[68Ga]FAPI PET/CT 与 [18F]FDG PET/CT 相比没有显著优势。然而，在某些情况下，[68Ga]FAPI PET/CT 可以作为 [18F]FDG PET/CT 的补充成像方法，尤其是在低 [18F]FDG 亲和力和结果不确定的情况下。鉴于 [68Ga]FAPI PET/CT 在 MM 中的有利方面，如背景活性低、不存在非特异性骨髓和生理性脑受累，应进行具有更大样本量的进一步研究。
