PET/CT 成像在原发性结直肠癌中检测成纤维细胞激活蛋白：与 18 F-FDG PET/CT 相比。

PET/CT imaging fibroblast activation protein in initial colorectal cancer: compared to 18 F-FDG PET/CT.

出版信息

Nucl Med Commun. 2023 Nov 1;44(11):1011-1019. doi: 10.1097/MNM.0000000000001751. Epub 2023 Sep 4.

Abstract

OBJECTIVE

In this study, the potential advantage of FAPI over 18 F-labelled deoxyglucose ( 18 F-FDG) in evaluation of the initial staging colorectal cancer (CRC) was investigated.

MATERIALS AND METHODS

Thirty-two patients with histopathologically confirmed primary CRC were included in our study. They all underwent both 18 F-FDG and FAPI PET/CT. Lesion detectability and tracer uptakes, mainly quantified by maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR), were compared for paired lesions between both modalities using the Wilcoxon signed-rank test and paired t-test.

RESULTS

Thirty-five CRC lesions in 32 patients were diagnosed. The sensitivity of FAPI PET/CT in diagnosis of the CRC lesions was 100% while 93.8% of 18 F-FDG PET/CT. FAPI and 18 F-FDG had a similar uptake in CRC lesion (mean SUVmax: 14.3 ± 8.6 vs. 15.4 ± 9.8, P = 0.604), but lesions contained mucus and/or signet-ring cell carcinoma seemed to have a trend of higher FAPI uptake although there was no statistical difference (mean SUVmax: 12.7 ± 5.6 vs. 8.5 ± 4.1, P = 0.152) and higher TBR (13.4 ± 6.2 vs. 4.9 ± 2.2, P = 0.004) than those of 18 F-FDG. For regional lymph node metastases, both FAPI and FDG PET/CTs showed high sensitivity (7/8 vs. 7/8), specificity (7/8 vs. 6/8) and accuracy (14/16 vs. 13/16) (all P > 0.05). For distant metastasis, FAPI PET/CT depicted more positive lesions in distant lymph node (46 vs. 26), liver (13 vs. 7) and peritoneum (107 vs. 45) than 18 F-FDG PET/CT. FAPI PET/CT also had a higher peritoneal cancer index score (median 11 vs 4; P < 0.001) than 18 F-FDG PET/CT in evaluation of peritoneal metastases.

CONCLUSION

FAPI PET/CT showed high sensitivity in detection of primary CRC and superiority to 18 F-FDG PET/CT in detection of metastases to distant lymph node, liver and peritoneum.

摘要

目的

本研究旨在探讨 FAPI 相较于 18 F-氟代脱氧葡萄糖（ 18 F-FDG）在评估初始结直肠癌（CRC）分期中的潜在优势。

材料与方法

本研究纳入了 32 例经组织病理学证实的原发性 CRC 患者。所有患者均行 18 F-FDG 和 FAPI PET/CT 检查。使用 Wilcoxon 符号秩检验和配对 t 检验比较两种方法中配对病变的病变检出率和示踪剂摄取情况，主要通过最大标准化摄取值（SUVmax）和靶标与背景比（TBR）进行定量评估。

结果

32 例患者共诊断出 35 处 CRC 病变。FAPI PET/CT 诊断 CRC 病变的灵敏度为 100%，而 18 F-FDG PET/CT 的灵敏度为 93.8%。FAPI 和 18 F-FDG 在 CRC 病变中的摄取相似（平均 SUVmax：14.3±8.6 比 15.4±9.8，P=0.604），但含有黏液和/或印戒细胞癌的病变似乎有更高的 FAPI 摄取趋势，尽管无统计学差异（平均 SUVmax：12.7±5.6 比 8.5±4.1，P=0.152）和更高的 TBR（13.4±6.2 比 4.9±2.2，P=0.004）。对于区域淋巴结转移，FAPI 和 FDG PET/CT 的灵敏度（7/8 比 7/8）、特异性（7/8 比 6/8）和准确性（14/16 比 13/16）均较高（均 P>0.05）。对于远处转移，FAPI PET/CT 在远处淋巴结（46 比 26）、肝脏（13 比 7）和腹膜（107 比 45）中显示出更多的阳性病变，优于 18 F-FDG PET/CT。FAPI PET/CT 在评估腹膜转移时还具有更高的腹膜肿瘤指数评分（中位数 11 比 4；P<0.001）。