Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital.
Department of Nuclear Medicine, Dicle University Faculty of Medicine, Diyarbakir.
Nucl Med Commun. 2022 Oct 1;43(10):1084-1091. doi: 10.1097/MNM.0000000000001607. Epub 2022 Aug 17.
In this study, we aimed to compare the diagnostic accuracy of 18 F-fluorodeoxyglucose ( 18 F-FDG) and Gallium-68 labeled fibroblast activator protein inhibitor ( 68 Ga-FAPI)-04 PET/CT in the tumor-node-metastasis (TNM) staging of patients with nonsmall cell lung cancer (NSCLC) and investigate whether adenocarcinoma (ADC) and squamous cell cancer (SCC) exhibit different uptake patterns on 68 Ga-FAPI-04 PET/CT.
Twenty-nine patients with a histopathologically-confirmed diagnosis of NSCLC, who had no history of previous radiation therapy or chemotherapy and underwent 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT imaging between January 2021 and December 2021 were included in this retrospective study. Staging was performed using the 8th edition of the TNM staging system on both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT images. Standardized uptake value (SUV) max and tumor-to-background ratios (TBR) were calculated on primary lesions and metastases.
There was no statistically significant difference in primary lesions in terms of SUV max and TBR values. However, 68 Ga-FAPI-04 PET/CT was significantly superior to 18 F-FDG PET/CT in terms of the number of lymph nodes and bone metastases revealed. The SUV max and TBR values of lymph nodes, hepatic lesions and bone lesions were significantly higher on 68 Ga-FAPI-04 PET/CT than on 18 F-FDG PET/CT. 68 Ga-FAPI-04 PET/CT changed the disease stage of three patients (10.9%). The diagnostic accuracy of 68 Ga-FAPI-04 PET/CT was 100%, whereas the diagnostic accuracy of 18 F-FDG PET/CT was 89.6% ( P = 0.250).
Although 68 Ga-FAPI-04 PET/CT detected more lesions and higher diagnostic accuracy than 18 F-FDG PET/CT in NSCLC, neither method was statistically superior to each other in terms of diagnostic accuracy in TNM staging.
本研究旨在比较 18 氟-脱氧葡萄糖（18 F-FDG）和镓-68 标记成纤维细胞激活蛋白抑制剂（68 Ga-FAPI）-04 PET/CT 在非小细胞肺癌（NSCLC）患者肿瘤-淋巴结-转移（TNM）分期中的诊断准确性，并探讨腺癌（ADC）和鳞状细胞癌（SCC）在 68 Ga-FAPI-04 PET/CT 上是否表现出不同的摄取模式。
本回顾性研究纳入了 29 例经组织病理学证实为 NSCLC 的患者，这些患者均无既往放疗或化疗史，并于 2021 年 1 月至 2021 年 12 月期间接受了 18 F-FDG PET/CT 和 68 Ga-FAPI-04 PET/CT 成像。在 18 F-FDG PET/CT 和 68 Ga-FAPI-04 PET/CT 图像上均使用第 8 版 TNM 分期系统进行分期。计算原发肿瘤和转移灶的最大标准摄取值（SUV）max 和肿瘤与背景比值（TBR）。
在 SUV max 和 TBR 值方面，原发肿瘤之间无统计学差异。然而，在显示淋巴结和骨转移方面，68 Ga-FAPI-04 PET/CT 明显优于 18 F-FDG PET/CT。与 18 F-FDG PET/CT 相比，68 Ga-FAPI-04 PET/CT 显示的淋巴结、肝病变和骨病变的 SUV max 和 TBR 值明显更高。68 Ga-FAPI-04 PET/CT 改变了 3 名患者（10.9%）的疾病分期。68 Ga-FAPI-04 PET/CT 的诊断准确性为 100%，而 18 F-FDG PET/CT 的诊断准确性为 89.6%（P=0.250）。
尽管 68 Ga-FAPI-04 PET/CT 在 NSCLC 中比 18 F-FDG PET/CT 检测到更多的病变和更高的诊断准确性，但在 TNM 分期的诊断准确性方面，两种方法均无统计学差异。
