Chen Ruohua, Yang Xinlan, Li Lianghua, Zhao Haitao, Huang Gang, Liu Jianjun
Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China.
Eur J Nucl Med Mol Imaging. 2025 Mar;52(4):1345-1353. doi: 10.1007/s00259-024-07029-6. Epub 2024 Dec 12.
While [ Ga]Ga-FAPI-04 PET/CT is widely used in various malignant tumors diagnosis, its specificity is challenged by high uptake in benign lesions such as inflammatory lymphadenopathy, bone fractures, and degenerative changes. This study aimed to quantitatively assess and characterize the metabolic heterogeneity of [ Ga]Ga-FAPI-04 uptake in benign and malignant lesions using dynamic total-body PET/CT.
Dynamic total-body [ Ga]Ga-FAPI-04 PET/CT scans (0-60 min post-injection) were performed on 17 oncology patients. Time-activity curves (TACs) were generated for benign and malignant lesions with high [ Ga]Ga-FAPI-04 uptake. The reversible two-tissue compartment model (2T4k) was used to derive kinetic metrics, including K, k, k, k, v and V. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values for differentiating benign and malignant lesions.
The study included 58 malignant and 55 inflammatory lesions with high [ Ga]Ga-FAPI-04 uptake. Malignant lesions exhibited higher K (0.277 ± 0.217 ml/ccm/min vs. 0.221 ± 0.216 ml/ccm/min, P = 0.011), v (0.042 ± 0.007 vs. 0.013 ± 0.004, P < 0.001), and lower k (0.267 ± 0.041 1/min vs. 0.481 ± 0.085 1/min, P = 0.008) compared to benign lesions. Lesions were classified into low, medium, and high-probability groups for being malignant based on K, k and v values, with probabilities of 0%, 50.7%, and 92.0%, respectively (P < 0.001).
Kinetic metrics, particularly K, k and v values, show promise as imaging biomarkers for distinguishing between benign and malignant lesions with high [ Ga]Ga-FAPI-04 uptake in oncology patients. These metrics reflect the metabolic heterogeneity of the lesions and may improve diagnostic accuracy in oncological imaging.
虽然[镓]镓-FAPI-04 PET/CT广泛应用于各种恶性肿瘤的诊断，但其特异性受到良性病变（如炎性淋巴结病、骨折和退行性改变）高摄取的挑战。本研究旨在使用动态全身PET/CT定量评估和表征[镓]镓-FAPI-04在良性和恶性病变中摄取的代谢异质性。
对17例肿瘤患者进行动态全身[镓]镓-FAPI-04 PET/CT扫描（注射后0-60分钟）。为[镓]镓-FAPI-04摄取高的良性和恶性病变生成时间-活性曲线（TAC）。使用可逆双组织室模型（2T4k）推导动力学指标，包括K、k、k、k、v和V。采用受试者工作特征（ROC）曲线分析确定区分良性和恶性病变的临界值。
该研究纳入了58例[镓]镓-FAPI-04摄取高的恶性病变和55例炎性病变。与良性病变相比，恶性病变表现出更高的K（0.277±0.217 ml/ccm/min对0.221±0.216 ml/ccm/min，P=0.011）、v（0.042±0.007对0.013±0.004，P<0.001），以及更低的k（0.267±0.041 1/min对0.481±0.085 1/min，P=0.008）。根据K、k和v值将病变分为低、中、高概率恶性组，概率分别为0%、50.7%和92.0%（P<0.001）。
动力学指标，特别是K、k和v值，有望作为影像学生物标志物，用于区分肿瘤患者中[镓]镓-FAPI-04摄取高的良性和恶性病变。这些指标反映了病变的代谢异质性，可能提高肿瘤影像学的诊断准确性。
