镓标记的FAPI-04与氟代脱氧葡萄糖PET/CT在复发性乳头状甲状腺癌患者转移灶诊断中的比较
Comparison of Ga-FAPI-04 and F-FDG PET/CT for diagnosis of metastatic lesions in patients with recurrent papillary thyroid carcinoma.
作者信息
Sayiner Zeynel Abidin, Elboğa Umut, Sahin Ertan, Ozturk Sadettin, Cayirli Yusuf Burak, Celen Yusuf Zeki, Akarsu Ersin, Dogan Ilkay, Kilbas Benan, Eryilmaz Kurtulus, Cakici Davut
机构信息
Gaziantep University, Department of Endocrinology and Metabolism, Turkey.
出版信息
Hell J Nucl Med. 2023 Jan-Apr;26(1):41-46. doi: 10.1967/s002449912560.
OBJECTIVE
We aimed to evaluate the gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography (PET/CT) in localizing papillary thyroid carcinoma (PTC) foci in patients with biochemical relapse. Papillary thyroid carcinoma has achieved biochemical recovery after appropriate treatment and had biochemical relapse in the last follow-up were included in this retrospective study. Gallium-68-FAPI and fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT were performed to detect recurrence foci.
SUBJECTS AND METHODS
Biochemically relapsed patients who underwent total thyroidectomy and were diagnosed with pathologically differentiated thyroid cancer were included in our study. Gallium-68-FAPI and F-FDG PET/CT imaging methods were used to determine the focus of metastasis or recurrence in all patients.
RESULTS
Among 29 patients enrolled to the study, pathological subgroups were papillary (n=26) and poorly differentiated (n=3) PTC. Anti-thyroglobulin (TG) antibody positivity were noted in 5 of the patients, while all 29 of them were TG positive and had been consist of three groups as follows: 2-10ng/mL (n=4), 11-300ng/mL (n=14), 301ng/mL and above (n=11). Recurrence was detected in 72.4% (n=21) and 86% (n=25) of the patients via F-FDG and Ga-FAPI, respectively. Accuracy of detection noted as 100% (5/5), 75% (3/4), and 92.9% (13/14) in groups with the anti-TG antibody positivity, TG levels of 2-10ng/mL and 11-300ng/mL, respectively, when the two imaging modalities were utilized together. Furthermore, accuracy of Ga-FAPI was 100% (11/11) in the group with TG levels of 301ng/mL and above, whereas accuracy of F-FDG was 81.8% (9/11). Lastly, median maximum standardized uptake value (SUVmax) of recurrent lesions detected by the Ga-FAPI (median SUVmax: 6.0) were statistically higher than the ones detected by the F-FDG (median SUVmax: 3.7) (P=0.002).
CONCLUSION
In recurrent PTC especially in case of higher TG levels, Ga-FAPI can be used in patients with inconclusive F-FDG findings.
目的
我们旨在评估镓-68标记的成纤维细胞激活蛋白抑制剂（Ga-FAPI）正电子发射断层扫描/计算机断层扫描（PET/CT）在定位生化复发的甲状腺乳头状癌（PTC）病灶中的应用。本回顾性研究纳入了经适当治疗后已实现生化缓解且在最后一次随访中出现生化复发的甲状腺乳头状癌患者。进行镓-68-FAPI和氟-18-氟脱氧葡萄糖（F-FDG）PET/CT检查以检测复发灶。
对象与方法
我们的研究纳入了接受全甲状腺切除术且病理诊断为分化型甲状腺癌的生化复发患者。使用镓-68-FAPI和F-FDG PET/CT成像方法确定所有患者的转移或复发灶。
结果
在纳入研究的29例患者中，病理亚组为乳头状（n = 26）和低分化（n = 3）PTC。5例患者抗甲状腺球蛋白（TG）抗体呈阳性，而所有29例患者TG均为阳性，并分为以下三组：2 - 10ng/mL（n = 4）、11 - 300ng/mL（n = 14）、301ng/mL及以上（n = 11）。分别通过F-FDG和Ga-FAPI检测到72.4%（n = 21）和86%（n = 25）的患者复发。当两种成像方式联合使用时，在抗TG抗体阳性组、TG水平为2 - 10ng/mL组和11 - 300ng/mL组中，检测准确率分别为100%（5/5）、75%（3/4）和92.9%（13/14）。此外，在TG水平为301ng/mL及以上的组中，Ga-FAPI的准确率为100%（11/11），而F-FDG的准确率为81.8%（9/11）。最后，Ga-FAPI检测到的复发灶的最大标准化摄取值（SUVmax）中位数（SUVmax中位数：6.0）在统计学上高于F-FDG检测到的复发灶（SUVmax中位数：3.7）（P = 0.002）。
结论
在复发性PTC中，尤其是在TG水平较高的情况下，对于F-FDG检查结果不明确的患者，可使用Ga-FAPI。
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