肝癌中纤维母细胞激活蛋白的影像学：单中心回顾性事后分析比较 [Ga]Ga-FAPI-04 PET/CT 与 MRI 和 [F]-FDG PET/CT。
Imaging fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [Ga]Ga-FAPI-04 PET/CT versus MRI and [F]-FDG PET/CT.
机构信息
Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China.
出版信息
Eur J Nucl Med Mol Imaging. 2021 May;48(5):1604-1617. doi: 10.1007/s00259-020-05095-0. Epub 2020 Nov 11.
PURPOSE
This study aimed to evaluate the potential utility of [Ga]Ga-FAPI-04 PET/CT for diagnosing primary and metastatic lesions in patients with liver cancer, as well as to compare it with contrast-enhanced CT (CE-CT), liver MRI, and [F]-FDG PET/CT.
METHODS
We performed a single-center post hoc retrospective analysis of data obtained from a prospective parent study (NCT04416165). This study included 34 patients diagnosed with or suspected hepatic lesions who underwent concomitant [Ga]Ga-FAPI-04 and [F]-FDG/CT scans. Moreover, these patients underwent liver MRI (n = 34) and CE-CT (n = 25). Histopathologic (n = 62) or radiographic follow-up (n = 128) served as the reference standard for the final diagnosis.
RESULTS
Among the 34 patients, 20, 12, and 2 patients presented with hepatocellular carcinomas, intrahepatic cholangiocarcinomas, and benign hepatic nodules, respectively. The sensitivities of CE-CT, MRI, [Ga]Ga-FAPI-04, and [F]-FDG/CT for detecting primary liver tumors were 96%, 100%, 96%, and 65%, respectively. Regarding the diagnosis of all intrahepatic lesions, the per-lesion detection rate of [Ga]Ga-FAPI-04 PET/CT was slightly lower than that of MRI (85% vs. 100%, P = 0.34) and significantly higher than that of [F]-FDG PET/CT (85% vs. 52%, P < 0.001). Regarding the diagnosis of all malignant lesions (including extrahepatic disease), the tumor detection rate of [Ga]Ga-FAPI-04 PET/CT was 87.4%, which was significantly higher than that of [F]-FDG PET/CT (65.0%, P < 0.001).
CONCLUSIONS
Our findings indicate that the sensitivity of [Ga]Ga-FAPI-04 PET/CT to correctly identify primary liver tumors and metastatic lesions is equivalent to that of CE-CT and liver MRI. Moreover, [Ga]Ga-FAPI-04 PET/CT is better at identifying liver lesions than [F]-FDG PET/CT, and its use may improve tumor staging, recurrence detection, and implementation of necessary treatment modifications.
目的
本研究旨在评估 [Ga]Ga-FAPI-04 PET/CT 对肝癌患者原发和转移病灶的诊断价值，并与增强 CT（CE-CT）、肝脏 MRI 和 [F]-FDG PET/CT 进行比较。
方法
我们对一项前瞻性的母研究（NCT04416165）的数据进行了单中心回顾性后分析。该研究纳入了 34 例经病理（n=62）或影像学随访（n=128）确诊或疑似肝脏病变的患者，这些患者同时进行了 [Ga]Ga-FAPI-04 和 [F]-FDG/CT 扫描。此外，这些患者还接受了肝脏 MRI（n=34）和 CE-CT（n=25）检查。
结果
34 例患者中，20 例、12 例和 2 例分别为肝细胞癌、肝内胆管细胞癌和良性肝结节。CE-CT、MRI、[Ga]Ga-FAPI-04 和 [F]-FDG/CT 对检测原发性肝癌的灵敏度分别为 96%、100%、96%和 65%。对于所有肝内病灶的诊断，[Ga]Ga-FAPI-04 PET/CT 的单病灶检出率略低于 MRI（85% vs. 100%，P=0.34），明显高于 [F]-FDG PET/CT（85% vs. 52%，P<0.001）。对于所有恶性病灶（包括肝外疾病）的诊断，[Ga]Ga-FAPI-04 PET/CT 的肿瘤检出率为 87.4%，明显高于 [F]-FDG PET/CT（65.0%，P<0.001）。
结论
我们的研究结果表明，[Ga]Ga-FAPI-04 PET/CT 对原发性肝癌和转移病灶的检出灵敏度与 CE-CT 和肝脏 MRI 相当。此外，[Ga]Ga-FAPI-04 PET/CT 对肝脏病灶的检出优于 [F]-FDG PET/CT，其应用可能改善肿瘤分期、检测复发和实施必要的治疗调整。
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