Wang Lijuan, Pan Xingzhu, Ye Shimin, Huang Yanchao, Wang Meng, Chen Li, Zhou Kemin, Han Yanjiang, Wu Hubing
Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, China.
Department of Nuclear Medicine, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
Eur J Nucl Med Mol Imaging. 2025 Apr;52(5):1685-1694. doi: 10.1007/s00259-024-07064-3. Epub 2025 Jan 6.
To explore the dynamic and parametric characteristics of [F]F-FAPI-42 PET/CT in lung cancers.
Nineteen participants with newly diagnosed lung cancer underwent 60-min dynamic [F]F-FAPI-42 PET/CT. Time-activity curves (TAC) were generated for tumors and normal organs, with kinetic parameters (K, K, K, K, K) calculated. A new parameter, the K ratio (K + K)/(K + K), was introduced to measure net uptake efficiency.
In primary tumor (PT), [F]F-FAPI-42 uptake showed a gradual increase followed by a plateau, contrasting with organs like the thyroid and pancreas, which showed rapid uptake and continuous washout. Compared to non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC) lesions reached the plateau earlier (11 min vs. 14 min) but had a lower uptake. During the plateau phase, [F]F-FAPI-42 demonstrated slight washout in SCLC, whereas its uptake increased slightly in NSCLC. Lymph node and distant metastases exhibited similar TAC profiles to primary tumors. Kinetic modeling revealed that an irreversible two-compartment model (irre-2TCM) best represented the pharmacokinetics of [F]F-FAPI-42 in lung cancer, whereas re-2TCM was better suited for the pancreas and thyroid. Lower K, K, K and K were observed in PT compared to those in the pancreas and thyroid (P < 0.05), however, the K ratio in PT was found to be 2-3 times higher. SCLC had lower K and SUVmean than NSCLC (P < 0.05). Kinetic parameter differences were also observed between PT and metastatic lesions. Larger metastatic lymph nodes exhibited higher K, K, and K ratio than smaller ones.
Lung cancers exhibit distinct [F]F-FAPI-42 dynamic and kinetic characteristics compared to the thyroid gland and pancreas. Differences were also observed between SCLC and NSCLC, primary and metastatic lesions, as well as larger versus smaller lesions. These findings provide valuable insights into the in vivo pharmacokinetics of [F]F-FAPI-42, potentially improving the diagnosis of lung cancer.
ChiCTR2100045757. Registered April 24, 2021 retrospectively registered, http//www.chictr.org.cn.
探讨[F]F-FAPI-42 PET/CT在肺癌中的动态和参数特征。
19例新诊断肺癌患者接受了60分钟的动态[F]F-FAPI-42 PET/CT检查。生成肿瘤和正常器官的时间-活性曲线（TAC），并计算动力学参数（K、K、K、K、K）。引入一个新参数K比（K+K）/（K+K）来衡量净摄取效率。
在原发性肿瘤（PT）中，[F]F-FAPI-42摄取呈逐渐增加后趋于平稳，这与甲状腺和胰腺等器官不同，后者表现为快速摄取和持续清除。与非小细胞肺癌（NSCLC）相比，小细胞肺癌（SCLC）病变达到平稳期更早（11分钟对14分钟），但摄取较低。在平稳期，[F]F-FAPI-42在SCLC中表现出轻微清除，而在NSCLC中其摄取略有增加。淋巴结和远处转移灶的TAC曲线与原发性肿瘤相似。动力学建模显示，不可逆双室模型（irre-2TCM）最能代表[F]F-FAPI-42在肺癌中的药代动力学，而可逆双室模型（re-2TCM）更适合胰腺和甲状腺。与胰腺和甲状腺相比，PT中的K、K、K和K较低（P<0.05），然而，PT中的K比高出2至3倍。SCLC的K和SUVmean低于NSCLC（P<0.05）。PT和转移灶之间也观察到动力学参数差异。较大的转移淋巴结比较小的转移淋巴结表现出更高的K、K和K比。
与甲状腺和胰腺相比，肺癌表现出独特的[F]F-FAPI-42动态和动力学特征。在SCLC和NSCLC、原发性和转移灶以及较大和较小病灶之间也观察到差异。这些发现为[F]F-FAPI-42的体内药代动力学提供了有价值的见解，可能改善肺癌的诊断。
ChiCTR2100045757。2021年4月24日回顾性注册，http//www.chictr.org.cn。
