Fibroblast Activation Protein-Targeted PET/CT with 18F-Fibroblast Activation Protein Inhibitor-74 for Evaluation of Gastrointestinal Cancer: Comparison with 18F-FDG PET/CT

被引:10
|
作者
Xu, Weizhi [1 ,2 ,3 ]
Cai, Jiayu [1 ,2 ,3 ]
Peng, Tianxing [1 ,2 ,3 ]
Meng, Tinghua [1 ,2 ,3 ]
Pang, Yizhen [1 ,2 ,3 ]
Sun, Long [1 ,2 ,3 ]
Wu, Hua [1 ,2 ,3 ]
Zhang, Jingjing [4 ,5 ,6 ,7 ]
Chen, Xiaoyuan [4 ,5 ,6 ,7 ,8 ]
Chen, Haojun [1 ,2 ,3 ]
机构
[1] Xiamen Univ, Affiliated Hosp 1, Dept Nucl Med, Xiamen, Peoples R China
[2] Xiamen Univ, Affiliated Hosp 1, Minnan PET Ctr, Xiamen, Peoples R China
[3] Xiamen Univ, Sch Med, Xiamen Key Lab Radiopharmaceut, Xiamen, Peoples R China
[4] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Diagnost Radiol, Singapore, Singapore
[5] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, Singapore
[6] Natl Univ Singapore, Coll Design & Engn, Dept Chem & Biomol Engn, Singapore, Singapore
[7] Natl Univ Singapore, Coll Design & Engn, Dept Biomed Engn, Singapore, Singapore
[8] ASTAR, Agcy Sci Technol & Res ASTAR, Singapore, Singapore
基金
中国国家自然科学基金; 新加坡国家研究基金会; 英国医学研究理事会;
关键词
PET; CT; 18F-FAPI-74; 18F-FDG; gastrointestinal tumors; POSITRON-EMISSION-TOMOGRAPHY; GASTRIC-CANCER; TUMOR; PROGNOSIS;
D O I
10.2967/jnumed.123.266329
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Fibroblast activation protein is overexpressed in the stroma of several cancer types. F-18-fibroblast activation protein inhibitor (FAPI)-74 is a PET tracer with high selectivity for fibroblast activation protein and has shown high accumulation in human tumors in clinical studies. However, the use of F-18-FAPI-74 for PET imaging of gastrointestinal cancer has not been systematically investigated. Herein, we investigated the diagnostic accuracy of F-18-FAPI-74 (F-18-LNC1005) PET/CT in gastric, liver, and pancreatic cancers and compared the results with those of F-18-FDG PET/CT. Methods: This prospective study analyzed patients with confirmed gastric, liver, or pancreatic malignancies who underwent concurrent F-18-FDG and F-18-FAPI-74 PET/CT between June 2022 and December 2022. PET/CT findings were confirmed by histopathology or radiographic follow-up. F-18-FDG and F-18-FAPI-74 uptake and tumor-to-background ratios were compared using the Wilcoxon signed-rank test. The McNemar test was used to compare the diagnostic accuracy of the 2 scans. Results: Our cohort consisted of 112 patients: 49 with gastric cancer, 39 with liver cancer, and 24 with pancreatic cancer. Among them, 69 patients underwent PET/CT for initial staging and 43 for recurrence detection. Regarding lesion-based diagnostic accuracy, F-18-FAPI-74 PET/CT showed higher sensitivity than did F-18-FDG in the detection of primary tumors (gastric cancer, 88% [22/25] vs. 60% [15/25], P = 0.016; liver cancer, 100% [22/22] vs. 82% [18/22], P = 0.125; pancreatic cancer, 100% [22/22] vs. 86% [19/22], P = 0.250), local recurrence (92% [23/25] vs. 56% [14/25]; P = 0.021), involved lymph nodes (71% [41/58] vs. 40% [23/58]; P < 0.001), and bone and visceral metastases (98% [350/358] vs. 47% [168/358]; P < 0.001). Compared with F-18-FDG, F-18-FAPI-74 PET/CT upstaged 17 patients' TNM staging among all treatment-na & iuml;ve patients (17/69, 25%) and changed the clinical management of 4 patients (4/43, 9%) in whom recurrence or metastases were detected. Conclusion: F-18-FAPI-74 PET/CT is superior to F-18-FDG PET/CT in detecting primary tumors, local recurrence, lymph node involvement, and bone and visceral metastases in gastric, pancreatic, and liver cancers, with higher uptake in most primary and metastatic lesions.
引用
收藏
页码:40 / 51
页数:12
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