Wang An-Bo, Feng Li-Jia, Ni Ping-Ping, He Li-Meng, Li Hong-Mei, Zhang Wei
Department of Nuclear Medicine,the First People's Hospital of Neijiang,Neijiang,Sichuan 641000,China.
Department of Nuclear Medicine,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Jun;45(3):440-444. doi: 10.3881/j.issn.1000-503X.15221.
Objective To investigate the causes of false-positive results in the Ga-labeled fibroblast activation protein inhibitor (Ga-FAPI-04) PET/CT imaging. Methods The imaging data of 547 patients undergoing Ga-FAPI-04 PET/CT examination in the Department of Nuclear Medicine of the Affiliated Hospital of Southwest Medical University from September 2020 to May 2021 were retrospectively collected.Two experienced nuclear medicine diagnostic physicians analyzed the clinical data,relevant imaging examinations,laboratory examinations,pathological results and follow-up results of the patients with false-positive results. Results The Ga-FAPI-04 PET/CT imaging of 547 patients showed false-positive results in 99 (18.1%) patients,including 56 males and 43 females.The postoperative pathological examination confirmed false-positive results in 13 patients,including 1 patient of thyroiditis,2 patients of pulmonary tuberculosis,1 patient of bone tuberculosis,2 patients of pulmonary inflammatory pseudotumor,1 patient of pulmonary sarcoidosis,1 patient of pulmonary benign fibroma,1 patient of organic pneumonia,2 patients of renal angiomyolipoma,1 patient of mass pancreatitis,and 1 patient of pancreatic mucinous cystadenoma.The medical history,relevant imaging examination,and long-term follow-up confirmed false-positive results in 86 patients.Specifically,the false-positive uptake in the neck,chest,abdomen,bone joint,and skin occurred in 8 (9.3%),13 (15.1%),5 (5.8%),57 (66.3%),and 3 (3.5%) patients,respectively.Inflammation-related uptake appeared in 83 (83.8%) patients with false-positive imaging results,of which arthritis (23 patients) and osteophyte (29 patients) were the most common.Sixteen (16.2%) patients showed the false-positive uptake related to fibroblasts. Conclusion Ga-FAPI-04 PET/CT imaging will show non-malignant tumor false-positive results,which are mainly associated with inflammation and fibroblasts.
目的 探讨镓标记的成纤维细胞活化蛋白抑制剂（Ga-FAPI-04）PET/CT成像假阳性结果的原因。方法 回顾性收集2020年9月至2021年5月在西南医科大学附属医院核医学科行Ga-FAPI-04 PET/CT检查的547例患者的影像资料。两名经验丰富的核医学诊断医师对出现假阳性结果患者的临床资料、相关影像检查、实验室检查、病理结果及随访结果进行分析。结果 547例患者的Ga-FAPI-04 PET/CT成像中有99例（18.1%）出现假阳性结果，其中男性56例，女性43例。术后病理检查证实13例为假阳性结果，包括1例甲状腺炎、2例肺结核、1例骨结核、2例肺炎性假瘤、1例肺结节病、1例肺良性纤维瘤、1例机化性肺炎、2例肾血管平滑肌脂肪瘤、1例肿块型胰腺炎、1例胰腺黏液性囊腺瘤。病史、相关影像检查及长期随访证实86例为假阳性结果。具体而言，颈部、胸部、腹部、骨关节及皮肤的假阳性摄取分别发生在8例（9.3%）、13例（15.1%）、5例（5.8%）、57例（66.3%）及3例（3.5%）患者中。炎症相关摄取出现在83例（83.8%）假阳性影像结果患者中，其中关节炎（23例）和骨赘（29例）最为常见。16例（16.2%）患者显示与成纤维细胞相关的假阳性摄取。结论 Ga-FAPI-04 PET/CT成像会出现非恶性肿瘤假阳性结果，主要与炎症和成纤维细胞有关。
