Jiang Chengzhi, Zheng Kai, Zhang Yanyin, Peng Xiang, Yang Jian, Ye Hui, Chen Yue
Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China (C.J., Y.C.); Department of PET-CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (C.J., K.Z., Y.Z., X.P., J.Y., H.Y.); Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China (C.J., Y.C.); Institute of Nuclear Medicine, Southwest Medical University, Luzhou, China (C.J., Y.C.).
Department of PET-CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (C.J., K.Z., Y.Z., X.P., J.Y., H.Y.).
Acad Radiol. 2025 Jun 19. doi: 10.1016/j.acra.2025.05.067.
In this study, we aimed to compared the performance of [F]FAPI-04 and [F]fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET/CT) in the evaluation of peritoneal carcinomatosis.
71 patients with suspected peritoneal malignancies were enrolled in our study. All the participants underwent both [F]FAPI-04 and [F]FDG PET/CT imaging within 7 days. The detection rates, diagnostic accuracies, semiquantitative parameters of the tracers, peritoneal cancer index (PCI) scores, and tumor markers were evaluated and compared.
Among the 71 patients, 40 patients were diagnosed with peritoneal carcinomatosis, and 31 were true-negative patients. The sensitivity and accuracy of [F]FAPI-04 PET/CT were higher than those of [F]FDG PET/CT (sensitivity: 92.50% vs. 72.50%, p=0.003; accuracy: 91.55% vs. 80.28%, p<0.001), particularly in patients with gastric cancer. The SUVmax, tumor-to-liver background ratio (TBR-L), tumor-to-descending aorta ratio (TBR-A), and PCI score were significantly higher for [F]FAPI-04 PET/CT than [F]FDG PET/CT (all p<0.05). In the [F]FAPI-04 PET/CT group, the PCI score, TBR-L, TBR-A, TBR-M and SUVmax were higher in the high level group than the low level group (all p<0.05). The carbohydrate antigen 125 (CA 125) levels were strongly correlated with the PCI of both [F]FAPI-04 and [F]FDG PET/CT.
[F]FAPI-04 PET/CT outperformed [F]FDG PET/CT in the evaluation of peritoneal carcinomatosis, particularly in patients with gastric cancer. Furthermore, [F]FAPI-04 PET/CT may be used for the assessment of peritoneal carcinomatosis in patients, especially FAPI-PCI.
在本研究中，我们旨在比较[F]FAPI - 04和[F]氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在评估腹膜癌转移方面的性能。
71例疑似腹膜恶性肿瘤患者纳入本研究。所有参与者在7天内均接受了[F]FAPI - 04和[F]FDG PET/CT成像。对示踪剂的检出率、诊断准确性、半定量参数、腹膜癌指数（PCI）评分和肿瘤标志物进行了评估和比较。
71例患者中，40例被诊断为腹膜癌转移，31例为真阴性患者。[F]FAPI - 04 PET/CT的敏感性和准确性高于[F]FDG PET/CT（敏感性：92.50%对72.50%，p = 0.003；准确性：91.55%对80.28%，p < 0.001），尤其是在胃癌患者中。[F]FAPI - 04 PET/CT的SUVmax、肿瘤与肝脏背景比值（TBR - L）、肿瘤与降主动脉比值（TBR - A）和PCI评分显著高于[F]FDG PET/CT（均p < 0.05）。在[F]FAPI - 04 PET/CT组中，高水平组的PCI评分、TBR - L、TBR - A、TBR - M和SUVmax高于低水平组（均p < 0.05）。糖类抗原125（CA 125）水平与[F]FAPI - 04和[F]FDG PET/CT的PCI均密切相关。
在评估腹膜癌转移方面，[F]FAPI - 04 PET/CT优于[F]FDG PET/CT，尤其是在胃癌患者中。此外，[F]FAPI - 04 PET/CT可用于评估患者的腹膜癌转移，特别是FAPI - PCI。
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