[68Ga]Ga-DOTA-FAPI-04 PET/CT 比 2-[F]FDG PET/CT 在 NSCLC 临床分期中具有更高的准确性。
Higher accuracy of [ Ga]Ga-DOTA-FAPI-04 PET/CT comparing with 2-[F]FDG PET/CT in clinical staging of NSCLC.
机构信息
Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China.
出版信息
Eur J Nucl Med Mol Imaging. 2022 Jul;49(8):2983-2993. doi: 10.1007/s00259-022-05818-5. Epub 2022 May 11.
PURPOSE
This study aimed to explore the clinical staging performance of [ Ga]Ga-DOTA-FAPI-04 PET/CT compared with that of 2-[F]FDG PET/CT in non-small cell lung cancer (NSCLC) patients lesion by lesion.
METHODS
A total of 134 diagnosed or suspected NSCLC patients were enrolled in the prospective study (ChiCTR2000038080); they received paired 2-[F]FDG PET/CT and [ Ga]Ga-DOTA-FAPI-04 PET/CT. Of these patients, the retrospective analysis of 74 NSCLC patients with pathological results was conducted from primary tumor (T) diagnosis, lymph node (N), and metastatic lesion (M) staging. The imaging characteristics of the lung nodules and suspected metastases were obtained and analyzed, and the staging performance of 2-[F]FDG PET/CT and [ Ga]Ga-DOTA-FAPI-04 PET/CT was compared.
RESULTS
For T diagnosis, [ Ga]Ga-DOTA-FAPI-04 showed better diagnostic performance than 2-[F]FDG in 79 lung nodules of 72 patients, especially for nonsolid and small-dimension adenocarcinoma nodules. For N staging, 98 lymph nodes (LNs) with pathological results in 37 patients were analyzed. The SUV of [ Ga]Ga-DOTA-FAPI-04 in the nonmetastatic LNs was significantly lower than that in the metastatic LNs. Regarding metastatic LN identification, the calculated optimum cut-off value of [ Ga]Ga-DOTA-FAPI-04 SUV was 5.5, and the diagnostic accuracy using [ Ga]Ga-DOTA-FAPI-04 and 2-[F]FDG criteria was 94% and 30%, respectively (P < 0.001). For M staging, [ Ga]Ga-DOTA-FAPI-04 identified more lesions than 2-[F]FDG (257 vs. 139 lesions) in 14 patients with multiple metastases. Overall, the staging accuracy of [ Ga]Ga-DOTA-FAPI-04 was better than that of 2-[F]FDG in 52 patients with different pathological stages [43/52 (82.7%) vs. 27/52 (51.9%), P = 0.001].
CONCLUSION
Compared with 2-[F]FDG PET/CT, [ Ga]Ga-DOTA-FAPI-04 PET/CT demonstrated better staging performance in NSCLC patients with different pathological stages, especially those with localized disease.
目的
本研究旨在探讨[68Ga]Ga-DOTA-FAPI-04 PET/CT 与 2-[F]FDG PET/CT 对非小细胞肺癌（NSCLC）患者病灶临床分期的表现。
方法
共纳入 134 例经诊断或疑似 NSCLC 的患者参与前瞻性研究（ChiCTR2000038080）；他们接受了配对的 2-[F]FDG PET/CT 和 [68Ga]Ga-DOTA-FAPI-04 PET/CT 检查。对其中 74 例有病理结果的 NSCLC 患者进行回顾性分析，包括原发肿瘤（T）、淋巴结（N）和转移病灶（M）分期。获取并分析肺部结节和疑似转移灶的影像学特征，并比较 2-[F]FDG PET/CT 和 [68Ga]Ga-DOTA-FAPI-04 PET/CT 的分期性能。
结果
对于 T 诊断，[68Ga]Ga-DOTA-FAPI-04 在 72 例患者的 79 个肺结节中显示出优于 2-[F]FDG 的诊断性能，尤其是对于非实性和小尺寸腺癌结节。对于 N 分期，对 37 例患者的 98 个有病理结果的淋巴结（LNs）进行了分析。非转移性 LNs 中[68Ga]Ga-DOTA-FAPI-04 的 SUV 明显低于转移性 LNs。对于转移性 LN 的识别，[68Ga]Ga-DOTA-FAPI-04 SUV 的最佳截断值计算为 5.5，使用[68Ga]Ga-DOTA-FAPI-04 和 2-[F]FDG 标准的诊断准确性分别为 94%和 30%（P<0.001）。对于 M 分期，[68Ga]Ga-DOTA-FAPI-04 在 14 例多发转移患者中比 2-[F]FDG 发现了更多的病灶（257 个与 139 个病灶）。总体而言，在不同病理分期的 52 例患者中，[68Ga]Ga-DOTA-FAPI-04 的分期准确性优于 2-[F]FDG [43/52（82.7%）与 27/52（51.9%），P=0.001]。
结论
与 2-[F]FDG PET/CT 相比，[68Ga]Ga-DOTA-FAPI-04 PET/CT 在不同病理分期的 NSCLC 患者中表现出更好的分期性能，尤其是在局限性疾病患者中。
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