Zheng Shan, Lin Junyu, Zhu Youzhi, Chen Yun, Zhang Jiaying, Chen Xiangjin, Miao Weibing
From the Department of Nuclear Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Clin Nucl Med. 2023 Mar 1;48(3):e104-e109. doi: 10.1097/RLU.0000000000004523. Epub 2023 Jan 10.
This study aimed to compare the performance of 68Ga-FAPI and 18F-FDG PET/CT in the evaluation of patients with newly diagnosed breast cancer.
Thirty-four women with newly diagnosed breast cancer who underwent both 68Ga-FAPI and 18F-FDG PET/CT within 1 week were prospectively included in the study. The imaging characteristics of primary lesions, diagnostic efficiency of lymph node metastasis (LNM), and accuracy of N stage evaluation between 2 PET/CTs were compared.
68Ga-FAPI showed higher SUVmax (11.06 ± 5.48 vs 8.33 ± 6.07, P = 0.02) and tumor-to-background ratio (15.32 ± 10.33 vs 8.25 ± 5.51, P < 0.001) than 18F-FDG in primary tumors. 68Ga-FAPI SUVmax was positively correlated with the pathological grade of the primary lesions and the final stage of the patients (P < 0.001). The specificity and accuracy of 68Ga-FAPI was higher than that of 18F-FDG in the diagnosis of LNMs on patient-based and lesion-based analysis (P < 0.001). The accuracy for the evaluation of N stage and N0 axillar status was 91.2% (31/34) and 85.7% (12/14) for 68Ga-FAPI, and 73.5% (25/34) and 42.9% (6/14) for 18F-FDG, respectively.
The 68Ga-FAPI SUVmax was positively correlated with the pathological grade of the primary lesions and the final stage of the patients. 68Ga-FAPI PET/CT has higher accuracy than 18F-FDG in the evaluation of N stage, especially N0 axillar status, which is helpful to improve the treatment strategy for breast cancer patients.
本研究旨在比较68Ga-FAPI和18F-FDG PET/CT在新诊断乳腺癌患者评估中的性能。
前瞻性纳入34例新诊断乳腺癌女性患者，她们在1周内先后接受了68Ga-FAPI和18F-FDG PET/CT检查。比较了两种PET/CT的原发灶影像特征、淋巴结转移（LNM）诊断效率以及N分期评估的准确性。
在原发肿瘤中，68Ga-FAPI的SUVmax（11.06±5.48 vs 8.33±6.07，P = 0.02）和肿瘤与背景比值（15.32±10.33 vs 8.25±5.51，P < 0.001）均高于18F-FDG。68Ga-FAPI的SUVmax与原发灶病理分级及患者最终分期呈正相关（P < 0.001）。在基于患者和基于病灶的分析中，68Ga-FAPI诊断LNM的特异性和准确性均高于18F-FDG（P < 0.001）。68Ga-FAPI评估N分期和腋窝N0状态的准确性分别为91.2%（31/34）和85.7%（12/14），18F-FDG分别为73.5%（25/34）和42.9%（6/14）。
68Ga-FAPI的SUVmax与原发灶病理分级及患者最终分期呈正相关。68Ga-FAPI PET/CT在N分期评估中，尤其是腋窝N0状态评估方面，比18F-FDG具有更高的准确性，这有助于改善乳腺癌患者的治疗策略。
