Department of Nuclear Medicine.
Department of Surgical Oncology.
Nucl Med Commun. 2023 Apr 1;44(4):276-283. doi: 10.1097/MNM.0000000000001661. Epub 2023 Feb 9.
To evaluate the role of Ga-68 fibroblast activation protein inhibitor 04 PET/computed tomography (FAPI) in colorectal cancers (CRCs) in terms of diagnostic accuracy and impact on clinical management. FAPI is compared with FDG PET/CT and conventional imaging in staging, restaging, recurrence detection, and response evaluation of CRC.
Twenty-nine consecutive patients of histopathologically confirmed primary or relapsed CRC were included in the study. Patients who underwent FAPI PET/CT along with either FDG PET/CT or conventional imaging were included. Primary lesions, recurrence sites, lymph nodes, and metastatic lesions were recorded on all the scans. Maximum standardized uptake value (SUVmax) was measured from both primary and metastatic lesions.
The sensitivity of FAPI in primary and recurrence detection is 100% compared to 88% for FDG/conventional imaging. The overall sensitivity of FAPI stands at 98% with accuracy at 95% whereas for FDG/conventional imaging the sensitivity and accuracy are 78% and 77%, respectively, with P < 0.002. Significant difference was noted in the detection of peritoneal metastasis (96% vs. 66%).
FAPI PET/CT shows better sensitivity and accuracy in the evaluation of CRCs, especially in peritoneal disease compared to FDG PET/CT and conventional imaging. FAPI has the potential to replace FDG in CRCs.
评估 Ga-68 成纤维细胞激活蛋白抑制剂 04 PET/计算机断层扫描（FAPI）在结直肠癌（CRC）中的诊断准确性和对临床管理的影响。将 FAPI 与 FDG PET/CT 和常规影像学进行比较，用于 CRC 的分期、再分期、复发检测和反应评估。
本研究纳入了 29 例经组织病理学证实的原发性或复发性 CRC 患者。入组患者均行 FAPI PET/CT 检查，并同时行 FDG PET/CT 或常规影像学检查。记录所有扫描的原发灶、复发灶、淋巴结和转移灶。测量原发灶和转移灶的最大标准化摄取值（SUVmax）。
与 FDG/常规影像学相比，FAPI 在原发灶和复发灶检测中的敏感性为 100%，总体敏感性为 98%，准确性为 95%，而 FDG/常规影像学的敏感性和准确性分别为 78%和 77%，P<0.002。在腹膜转移的检测方面，FAPI 的敏感性（96%）明显高于 FDG（66%）。
与 FDG PET/CT 和常规影像学相比，FAPI PET/CT 在评估 CRC 方面具有更高的敏感性和准确性，尤其是在腹膜疾病方面。FAPI 有可能替代 FDG 在 CRC 中的应用。
