Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China.
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, VA.
Semin Nucl Med. 2024 Nov;54(6):904-913. doi: 10.1053/j.semnuclmed.2024.09.009. Epub 2024 Nov 2.
Fibroblast activation protein inhibitor (FAPI) and [F]fluorodeoxyglucose ([F]FDG) provide complementary biological information, and FAPI/FDG dual-tracer imaging clinical application is increasing recently. However, optimal protocols for FAPI/FDG dual-tracer positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance (PET/MR) imaging are still under investigation. Due to its high sensitivity, total-body PET/CT allows for imaging with minimal tracer activity and supports the creation of new dual-tracer PET/CT imaging protocols. PET/MR, with its multiparametric MR imaging, provides additional biological information for diagnosis. Studies have investigated the clinical feasibility of low-activity PET/MR imaging, yielding promising results. As there are still few institutions in the world that have experience with the advances provided by the use of total-body PET/CT and equipped with a PET/MR scanner, we have discussed the clinical explorations to reduce radiation exposure and optimize workflows for [Ga]Ga-FAPI-04 and [F]FDG dual-tracer PET/CT and PET/MR imaging. The review also provides potential new clinical explorations of [Ga]Ga-FAPI-04 and [F]FDG dual-tracer total-body PET/CT and PET/MR imaging, including dual-tracer dual-low-activity imaging.
成纤维细胞激活蛋白抑制剂（FAPI）和[F]氟脱氧葡萄糖（[F]FDG）提供互补的生物学信息，FAPI/FDG 双示踪剂成像的临床应用最近正在增加。然而，FAPI/FDG 双示踪剂正电子发射断层扫描/计算机断层扫描（PET/CT）和 PET/磁共振（PET/MR）成像的最佳方案仍在研究中。由于其高灵敏度，全身 PET/CT 允许使用最小的示踪剂活性进行成像，并支持创建新的双示踪剂 PET/CT 成像方案。具有多种参数的磁共振成像的 PET/MR 为诊断提供了额外的生物学信息。研究已经探讨了低活性 PET/MR 成像的临床可行性，结果令人鼓舞。由于世界上只有少数机构具有使用全身 PET/CT 提供的优势的经验，并且配备了 PET/MR 扫描仪，因此我们讨论了减少辐射暴露和优化[Ga]Ga-FAPI-04 和 [F]FDG 双示踪剂 PET/CT 和 PET/MR 成像工作流程的临床探索。该综述还提供了[Ga]Ga-FAPI-04 和 [F]FDG 双示踪剂全身 PET/CT 和 PET/MR 成像的潜在新的临床探索，包括双示踪剂双低活性成像。
