[镓]镓-FAPI-04 PET/CT与X线成像在类风湿关节炎患者评估中的比较。
Comparisons of [ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in the assessment of patients with rheumatoid arthritis.
作者信息
Yang Dan, Chen Jiana, He Guangyuan, Zhou Ziyue, Xu Jiaqi, Peng Yezi, Shen Xiangyi, Jiang Xu, Pan Qingqing, Zhao Lidan, Fei Yunyun, Luo Yaping, Yang Huaxia
机构信息
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
出版信息
Clin Rheumatol. 2025 Apr 28. doi: 10.1007/s10067-025-07414-y.
OBJECTIVE
This study aimed to compare the value of [ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in assessing disease activity and treatment response in patients with rheumatoid arthritis (RA).
METHOD
All patients underwent clinical and laboratory assessments, [ Ga]Ga-FAPI-04 PET/CT, and X-ray imaging, with a 6-month follow-up to assess disease activity and treatment response. Bland-Altman analysis assessed the agreement between PET/CT and X-ray parameters. Correlation analyses were performed between clinical characteristics and imaging parameters. Receiver operating characteristic (ROC) curve analyses were used to predict treatment response.
RESULTS
We prospectively enrolled 17 patients with RA (14 females and 3 males; median age, 55.0 yr [IQR: 50.0-58.5 yr]). [ Ga]Ga-FAPI-04 PET/CT showed strong agreement with X-ray in evaluating the number of joints involved. PET/CT imaging-derived parameters, including PET joint count (PJC), PET articular index (PAI), total synovitis uptake (TSU), and metabolic synovitis volume (MSV) were significantly correlated with C-reactive protein levels. Moreover, PJC and PAI were associated with tender or swollen joint count (TJC/SJC), disease activity score with 28-joint counts (DAS28), and Simplified Disease Activity Index (SDAI), respectively. No correlations were observed between the X-ray findings and disease activity parameters. The baseline PAI > cutoff values could discriminate responders and non-responders at the 6-month follow-up according to the Clinical Disease Activity Index (CDAI) and SDAI response criteria, while X-ray could not predict treatment response.
CONCLUSIONS
[ Ga]Ga-FAPI-04 PET/CT was superior to X-ray imaging in evaluating disease activity and predicting treatment response in patients with RA.
TRIAL REGISTRATION
ClinicalTrials. NCT04514614. Registered 13 August 2020, https://register.
CLINICALTRIALS
gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p.
目的
本研究旨在比较[镓]Ga-FAPI-04 PET/CT与X线成像在评估类风湿关节炎（RA）患者疾病活动度及治疗反应中的价值。
方法
所有患者均接受临床和实验室评估、[镓]Ga-FAPI-04 PET/CT及X线成像检查，并进行为期6个月的随访以评估疾病活动度及治疗反应。采用Bland-Altman分析评估PET/CT与X线参数之间的一致性。对临床特征与影像参数进行相关性分析。采用受试者操作特征（ROC）曲线分析预测治疗反应。
结果
我们前瞻性纳入了17例RA患者（14例女性，3例男性；中位年龄55.0岁[四分位间距：50.0 - 58.5岁]）。[镓]Ga-FAPI-04 PET/CT在评估受累关节数量方面与X线表现出高度一致性。PET/CT成像得出的参数，包括PET关节计数（PJC）、PET关节指数（PAI）、滑膜总摄取量（TSU）及代谢性滑膜炎体积（MSV）与C反应蛋白水平显著相关。此外，PJC和PAI分别与压痛或肿胀关节计数（TJC/SJC）、28个关节计数的疾病活动评分（DAS28）及简化疾病活动指数（SDAI）相关。X线检查结果与疾病活动参数之间未观察到相关性。根据临床疾病活动指数（CDAI）和SDAI反应标准，基线PAI > 临界值可在6个月随访时区分反应者与无反应者，而X线无法预测治疗反应。
结论
[镓]Ga-FAPI-04 PET/CT在评估RA患者疾病活动度及预测治疗反应方面优于X线成像。
试验注册
ClinicalTrials. NCT04514614。于2020年8月13日注册，https://register.
临床试验
gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p。
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