Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
Eur J Nucl Med Mol Imaging. 2022 Oct;49(12):4228-4240. doi: 10.1007/s00259-022-05847-0. Epub 2022 Jun 3.
Gallium-68-labeled fibroblast activation protein inhibitor (Ga-FAPI) is an emerging promising tumor tracer. This study aims to evaluate the diagnostic efficiency of Ga-FAPI PET in gastrointestinal cancer, and to determine its potential impact on clinical management.
Patients with malignancies were prospectively enrolled in a clinical trial to evaluate the diagnostic value of Ga-FAPI PET. One hundred twenty patients with gastrointestinal malignancies (121 Ga-FAPI PET scans) between June 2020 and May 2021 were retrospectively analyzed. Initial staging of untreated patients and restaging of treated patients were evaluated. The treatment scheme promoted by imaging was determined according to NCCN guidelines. Final diagnosis and treatment reference standards were determined by a dedicated multidisciplinary team. The diagnostic performance and treatment guidance of Ga-FAPI PET were compared with those of conventional imaging (CI) and F-FDG PET.
The diagnostic accuracy of Ga-FAPI PET was much higher than that of CI and F-FDG PET (95.0% vs. 65.1% and 69.0%, respectively, both p < 0.001). Ga-FAPI PET revised diagnosis in 30.3% and 26.2% of patients compared with CI and F-FDG PET. The accordance rate of Ga-FAPI PET-guided treatment in comparison with the reference standard was significantly higher than that of CI and F-FDG PET (96.7% vs. 75.2% and 76.2%, respectively, both p < 0.001). Ga-FAPI PET changed treatment in 22.9% and 23.8% of patients compared with CI and F-FDG PET.
Ga-FAPI PET showed remarkable diagnostic performance in gastrointestinal cancer, resulting in more accurate staging and guidance for timely treatment revision, thereby having a critical impact on clinical management.
NCT04554719. Registered September 8, 2020-retrospectively registered, http://clinicaltrails.gov/show/NCT04554719.
镓-68 标记的成纤维细胞激活蛋白抑制剂（Ga-FAPI）是一种新兴的有前途的肿瘤示踪剂。本研究旨在评估 Ga-FAPI PET 在胃肠道癌中的诊断效率，并确定其对临床管理的潜在影响。
前瞻性纳入 2020 年 6 月至 2021 年 5 月间接受 Ga-FAPI PET 评估的恶性肿瘤患者进行临床试验，共纳入 121 例胃肠道恶性肿瘤患者（121 例 Ga-FAPI PET 扫描）。评估未经治疗患者的初始分期和经治疗患者的再分期。根据 NCCN 指南确定影像学检查促进的治疗方案。根据专门的多学科团队确定最终诊断和治疗参考标准。比较 Ga-FAPI PET 的诊断性能和治疗指导与常规成像（CI）和 F-FDG PET 的诊断性能和治疗指导。
Ga-FAPI PET 的诊断准确性明显高于 CI 和 F-FDG PET（95.0%比 65.1%和 69.0%，均 p<0.001）。与 CI 和 F-FDG PET 相比，Ga-FAPI PET 改变了 30.3%和 26.2%患者的诊断。与参考标准相比，Ga-FAPI PET 指导治疗的符合率明显高于 CI 和 F-FDG PET（96.7%比 75.2%和 76.2%，均 p<0.001）。与 CI 和 F-FDG PET 相比，Ga-FAPI PET 改变了 22.9%和 23.8%患者的治疗。
Ga-FAPI PET 在胃肠道癌中表现出显著的诊断性能，导致更准确的分期，并为及时治疗修改提供指导，从而对临床管理产生重大影响。
NCT04554719。2020 年 9 月 8 日注册-回顾性注册，http://clinicaltrails.gov/show/NCT04554719。
