Zheng Zhe, He Yibo, Mao Wujian, Yu Haojun, Wu Ha, Yang Runjun, Gao Huaping, Hu Pengcheng, Shi Hongcheng
Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
Eur J Nucl Med Mol Imaging. 2025 Jan;52(2):638-647. doi: 10.1007/s00259-024-06924-2. Epub 2024 Sep 25.
To validate the feasibility of one-stop 2-[F]fluoro-2-deoxy-D-glucose ([F]FDG) and [Ga]Ga-fibroblast activation protein inhibitor-04 ([Ga]Ga-FAPI-04) dual-low-activity-tracer positron emission tomography/computed tomography (PET/CT) at 34 min post-injection of [Ga]Ga-FAPI-04 and explore its additional value.
Thirty pairs of patients with suspected malignancies who underwent dual-tracer imaging were enrolled in this retrospective study. The images were reconstructed at 34-39 and 50-60 min after additional injection of [Ga]Ga-FAPI-04 (in one-stop FDG-FAPI PET/CT, named PET, PET, and PET; in the 2-day protocol, named PET, PET, and PET, respectively). Tumour-to-normal ratios (TNR) of lesions in PET, PET, and PET and TNR of lesions in PET and PET were evaluated separately. To evaluate the potential added value of one-stop FDG-FAPI PET/CT over the 2-day protocol, TNRs of PET, PET, and PET were compared with PET. The lesion detectability of the two imaging protocols was evaluated by chi-square test.
Comparing FAPI-weighted PET (PET and PET) and single-tracer imaging (PET) in one-stop FDG-FAPI PET/CT, TNRs of FAPI-weighted PET were higher than those of PET. PET and PET showed similar performance in lesion detectability and TNRs (all P > 0.05). In the 2-day protocol, there are no statistically significant differences in TNRs of all lesions at PET and PET. Comparing one-stop FDG-FAPI PET/CT with the 2-day protocol, TNRs of PET were significantly higher than those of PET but lower than those of PET and PET. Lesion detectability in the one-stop FDG-FAPI PET/CT was higher than that in the 2-day protocol. The average radiation dose in one-stop FDG-FAPI PET/CT was significantly lower than that in the 2-day protocol (P<0.001).
One-stop FDG-FAPI PET/CT at 34 min could provide sufficient information to meet clinical diagnosis and showed better lesion detectability than that in the 2-day protocol.
验证在注射[镓]Ga-成纤维细胞活化蛋白抑制剂-04（[镓]Ga-FAPI-04）后34分钟进行一站式2-[氟]氟-2-脱氧-D-葡萄糖（[氟]FDG）和[镓]Ga-FAPI-04双低活性示踪剂正电子发射断层扫描/计算机断层扫描（PET/CT）的可行性，并探讨其附加价值。
本回顾性研究纳入了30例接受双示踪剂成像的疑似恶性肿瘤患者。在额外注射[镓]Ga-FAPI-04后34 - 39分钟和50 - 60分钟重建图像（在一站式FDG-FAPI PET/CT中，分别命名为PET₁、PET₂和PET₃；在两日方案中，分别命名为PET₄、PET₅和PET₆）。分别评估PET₁、PET₂和PET₃中病变的肿瘤与正常组织比值（TNR）以及PET₄和PET₅中病变的TNR。为了评估一站式FDG-FAPI PET/CT相对于两日方案的潜在附加价值，将PET₁、PET₂和PET₃的TNR与PET₄进行比较。通过卡方检验评估两种成像方案的病变可检测性。
在一站式FDG-FAPI PET/CT中，比较FAPI加权PET（PET₁和PET₂）和单示踪剂成像（PET₃），FAPI加权PET的TNR高于PET₃。PET₁和PET₂在病变可检测性和TNR方面表现相似（所有P＞0.05）。在两日方案中，PET₄和PET₅中所有病变的TNR无统计学显著差异。将一站式FDG-FAPI PET/CT与两日方案进行比较，PET₁的TNR显著高于PET₄，但低于PET₂和PET₅。一站式FDG-FAPI PET/CT中的病变可检测性高于两日方案。一站式FDG-FAPI PET/CT的平均辐射剂量显著低于两日方案（P＜0.001）。
34分钟的一站式FDG-FAPI PET/CT能够提供足够的信息以满足临床诊断，并且与两日方案相比具有更好的病变可检测性。
