自身免疫性风湿病诊断中 F-FDG 与 AlF-NOTA-FAPI-04 PET/CT 成像的头对头比较。
Head to head comparison of F-FDG and AlF-NOTA-FAPI-04 PET/CT imaging used in diagnosis of autoimmune rheumatic diseases.
机构信息
Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
Department of Nuclear Medicine, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
出版信息
Clin Rheumatol. 2024 Nov;43(11):3497-3505. doi: 10.1007/s10067-024-07155-4. Epub 2024 Oct 1.
OBJECTIVES
The aim of this study was to determine the performance of radionuclide-labeled fibroblast activation protein inhibitors (AlF-NOTA-FAPI-04) PET/CT in patients with autoimmune rheumatic diseases (ARDs) and compare it with fluorine-18 (F) labeled fluorodeoxyglucose (FDG) imaging.
METHODS
Fifty-eight participants with ARDs were prospectively enrolled from April 2022 to February 2024 and underwent dual-tracer PET/CT imaging. For both F-FDG and AlF-NOTA-FAPI-04 PET/CT, imaging findings were interpreted and compared. The clinical significance was compared betweenF-FDG PET/CT and AlF-NOTA-FAPI-04 PET/CT imaging.
RESULTS
F-FDG imaging was positive in 53 out of 58 cases (91.4%) while AlF-NOTA-FAPI-04 imaging was positive in 55 out of 58 cases (94.8%). Overall positive rate of AlF-NOTA-FAPI-04 imaging was as high as F-FDG imaging (P = 0.625). F-FDG imaging detected more lesions in lymph node, spleen, and bone marrow. AlF-NOTA-FAPI-04 imaging detected more lesions in the lung, muscle, and tendon/ligament. There was no statistical difference of composing ratio of grades of clinical significance between two imaging modalities (χ = 2.875, P = 0.238). The superior rate of AlF-NOTA-FAPI-04 PET/CT imaging was higher than F-FDG imaging (P = 0.020). In subgroup of adult-onset Still's disease, F-FDG imaging showed better performance than AlF-NOTA-FAPI-04 imaging. In most of the other subgroup of ARDs, AlF-NOTA-FAPI-04 PET/CT imaging overperformed F-FDG imaging.
CONCLUSION
Both F-FDG and AlF-NOTA-FAPI-04 PET/CT imaging have excellent sensitivity in ARDs. The detection capabilities of two tracers varied according to the involving organs of ARDs. In most of ARDs except adult-onset Still's disease, AlF-NOTA-FAPI-04 PET/CT imaging overperformed F-FDG imaging. Key Points • F-FDG and Al18F-NOTA-FAPI-04 PET/CT imaging have excellent sensitivity in diagnosing of ARDs. • F-FDG PET/CT imaging detected more lesions in lymph node, spleen, and bone marrow. • F-NOTA-FAPI-04 PET/CT imaging detected more lesions in the lung, muscle, and tendon/ligament. • F-NOTA-FAPI-04 PET/CT imaging overperformedF-FDG in most subgroups of ARDs.
目的
本研究旨在评估放射性核素标记的成纤维细胞激活蛋白抑制剂（AlF-NOTA-FAPI-04）在自身免疫性风湿病（ARDs）患者中的 PET/CT 表现，并与氟-18（F）标记的氟脱氧葡萄糖（FDG）成像进行比较。
方法
前瞻性纳入 2022 年 4 月至 2024 年 2 月期间的 58 例 ARD 患者，进行双示踪剂 PET/CT 检查。对 F-FDG 和 AlF-NOTA-FAPI-04 PET/CT 成像结果进行解读和比较。比较 F-FDG 和 AlF-NOTA-FAPI-04 PET/CT 成像的临床意义。
结果
58 例患者中，53 例（91.4%）F-FDG 成像阳性，55 例（94.8%）AlF-NOTA-FAPI-04 成像阳性。AlF-NOTA-FAPI-04 成像的总体阳性率与 F-FDG 成像相当（P=0.625）。F-FDG 成像检测到更多淋巴结、脾脏和骨髓中的病变，而 AlF-NOTA-FAPI-04 成像检测到更多肺部、肌肉和肌腱/韧带中的病变。两种成像方式的临床意义分级构成比无统计学差异（χ²=2.875，P=0.238）。AlF-NOTA-FAPI-04 PET/CT 成像的优势率高于 F-FDG 成像（P=0.020）。在成人Still 病亚组中，F-FDG 成像的表现优于 AlF-NOTA-FAPI-04 成像。在大多数其他 ARD 亚组中，AlF-NOTA-FAPI-04 PET/CT 成像的表现优于 F-FDG 成像。
结论
F-FDG 和 AlF-NOTA-FAPI-04 PET/CT 成像在 ARD 中的诊断均具有较高的灵敏度。两种示踪剂的检测能力因 ARD 受累器官而异。在除成人Still 病以外的大多数 ARD 中，AlF-NOTA-FAPI-04 PET/CT 成像的表现优于 F-FDG 成像。
关键点
F-FDG 和 Al18F-NOTA-FAPI-04 PET/CT 成像在诊断 ARD 方面具有出色的灵敏度。
F-FDG PET/CT 成像检测到更多淋巴结、脾脏和骨髓中的病变。
F-NOTA-FAPI-04 PET/CT 成像检测到更多肺部、肌肉和肌腱/韧带中的病变。
在大多数 ARD 亚组中，F-NOTA-FAPI-04 PET/CT 成像优于 F-FDG 成像。
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