Ma Wenhui, Yang Shu, Ye Jiajun, Quan Zhiyong, Zhang Mingru, Li Guiyu, Zhu Zifan, Wang Jia, Ma Taoqi, Wang Junling, Liu Yu, Liu Zhibo, Kang Fei, Wang Jing
Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Beijing National Laboratory for Molecular Sciences, Radiochemistry and Radiation Chemistry Key Laboratory of Fundamental Science, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, Peking University, Beijing, China.
Eur J Nucl Med Mol Imaging. 2025 Jun 4. doi: 10.1007/s00259-025-07372-2.
FT-FAPI (FT, fast treatment) is a new FAP inhibitor with the potential to be used as a drug in boron neutron capture therapy (BNCT). The aim of this prospective study was to compare the diagnostic performance of Ga-FT-FAPI and Ga-FAPI-04 in patients with gastrointestinal (GI) tumors.
The study enrolled patients with histologically confirmed GI tumors diagnosed between March 2024 to April 2025 in Xijing Hospital. All the patients underwent paired Ga-FT-FAPI PET/CT and Ga-FAPI-04 PET/CT scans within three days. The maximum standard uptake value (SUVmax), tumor-to-background ratio (TBR), and retention index (RI) of the primary tumor and metastatic lesions were analyzed for both imaging modalities.
A total of 19 patients with GI tumors (12 males and 7 females) with a median age of 61.3 years (range, 40-75 years) were finally enrolled in this study. A total of 186 lesions were identified.Ga-FT-FAPI identified all the tumors clearly with a higher uptake than Ga-FAPI-04 (13.3 vs. 10.0, P < 0.001), and better TBR (13.8 vs. 8.2, P < 0.001). In terms of retention, the RIs of Ga-FT-FAPI were significantly higher than those of Ga-FAPI-04 for detecting lymph node metastases (88.7% vs. 76.2%, P = 0.001, n = 62), liver metastases (115.4% vs. 101.5%, P = 0.032, n = 38), bone metastases (70.8% vs. 57.0%, P = 0.008, n = 24), and peritoneal metastases (102.9% vs. 87.0%, P = 0.041, n = 26).
Ga-FT-FAPI had a superior performance than Ga-FAPI-04 for uptake in lesions and a higher detection rate, especially for identifying metastases in lymph nodes, bone, liver and peritoneum. Ga-FT-FAPI may therefore be an effective BNCT agent for diagnosis and treatment of GI tumors.
FT-FAPI（FT，快速治疗）是一种新型FAP抑制剂，有潜力用作硼中子俘获疗法（BNCT）中的药物。本前瞻性研究的目的是比较Ga-FT-FAPI和Ga-FAPI-04在胃肠道（GI）肿瘤患者中的诊断性能。
本研究纳入了2024年3月至2025年4月在西京医院确诊的组织学确诊的GI肿瘤患者。所有患者在三天内接受了配对的Ga-FT-FAPI PET/CT和Ga-FAPI-04 PET/CT扫描。分析了两种成像方式下原发肿瘤和转移灶的最大标准摄取值（SUVmax）、肿瘤与背景比值（TBR）和滞留指数（RI）。
本研究最终纳入了19例GI肿瘤患者（12例男性和7例女性），中位年龄为61.3岁（范围40 - 75岁）。共识别出186个病灶。Ga-FT-FAPI能清晰识别所有肿瘤，摄取高于Ga-FAPI-04（13.3对10.0，P < 0.001），且TBR更好（13.8对8.2，P < 0.001）。在滞留方面，Ga-FT-FAPI检测淋巴结转移（88.7%对76.2%，P = 0.001，n = 62）、肝转移（115.4%对101.5%，P = 0.032，n = 38）、骨转移（70.8%对57.0%，P = 0.008，n = 24）和腹膜转移（102.9%对87.0%，P = 0.041，n = 26）的RI显著高于Ga-FAPI-04。
Ga-FT-FAPI在病灶摄取方面的表现优于Ga-FAPI-04，检测率更高，尤其是在识别淋巴结、骨、肝和腹膜转移方面。因此，Ga-FT-FAPI可能是一种用于诊断和治疗GI肿瘤的有效BNCT药物。
