¹⁸F-FDG与⁶⁸Ga-FAPI PET/CT在常见妇科恶性肿瘤中的头对头比较。
Head-to-head comparison of F-FDG and Ga-FAPI PET/CT in common gynecological malignancies.
作者信息
Li Tengfei, Zhang Jintao, Yan Yuanzhuo, Zhang Yue, Pei Wenjie, Hua Qingchu, Chen Yue
机构信息
Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, PR China.
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, 646000, PR China.
出版信息
Cancer Imaging. 2025 Feb 28;25(1):21. doi: 10.1186/s40644-025-00843-7.
BACKGROUND
Ga-FAPI (fibroblast activation protein inhibitor) is a novel and highly promising radiotracer for PET/CT imaging. It has shown significant tumor uptake and high sensitivity in lesion detection across a range of cancer types. We aimed to compare the diagnostic value of Ga-FAPI and F-FDG PET/CT in common gynecological malignancies.
METHODS
This retrospective study included 35 patients diagnosed with common gynecological tumors, including breast cancer, ovarian cancer, and cervical cancer. Among the 35 patients, 27 underwent PET/CT for the initial assessment of tumors, while 8 were assessed for recurrence detection. The median and range of tumor size and maximum standardized uptake values (SUV) were calculated.
RESULTS
Thirty-five patients (median age, 57 years [interquartile range], 51-65 years) were evaluated. In treatment-naive patients (n = 27), Ga-FAPI PET/CT led to upstaging of the clinical TNM stage in five (19%) patients compared with F-FDG PET/CT. No significant difference in tracer uptake was observed between F-FDG and Ga-FAPI for primary lesions: breast cancer (7.2 vs. 4.9, P = 0.086), ovarian cancer (16.3 vs. 15.7, P = 0.345), and cervical cancer (18.3 vs. 17.1, P = 0.703). For involved lymph nodes, Ga-FAPI PET/CT demonstrated a higher SUV for breast cancer (9.9 vs. 6.1, P = 0.007) and cervical cancer (6.3 vs. 4.8, P = 0.048), while no significant difference was noted for ovarian cancer (7.0 vs. 5.9, P = 0.179). Furthermore, Ga-FAPI PET/CT demonstrated higher specificity and accuracy compared to F-FDG PET/CT for detecting metastatic lymph nodes (100% vs. 66%, P < 0.001; 94% vs. 80%, P < 0.001). In contrast, sensitivity did not differ significantly (97% vs. 86%, P = 0.125). For most distant metastases, Ga-FAPI exhibited a higher SUV than F-FDG in bone metastases (12.9 vs. 4.9, P = 0.036).
CONCLUSIONS
Ga-FAPI PET/CT demonstrated higher tracer uptake and was superior to F-FDG PET/CT in detecting primary and metastatic lesions in patients with common gynecological malignancies.
TRIAL REGISTRATION
ChiCTR, ChiCTR2100044131. Registered 10 October 2022, https://www.chictr.org.cn , ChiCTR2100044131.
背景
镓标记的成纤维细胞活化蛋白抑制剂（Ga-FAPI）是一种新型且极具前景的正电子发射断层显像/计算机断层扫描（PET/CT）成像放射性示踪剂。在一系列癌症类型中，它在病变检测中显示出显著的肿瘤摄取和高灵敏度。我们旨在比较Ga-FAPI和氟代脱氧葡萄糖（F-FDG）PET/CT在常见妇科恶性肿瘤中的诊断价值。
方法
这项回顾性研究纳入了35例被诊断为常见妇科肿瘤的患者，包括乳腺癌、卵巢癌和宫颈癌。在这35例患者中，27例接受PET/CT进行肿瘤的初始评估，而8例接受评估以检测复发情况。计算肿瘤大小和最大标准化摄取值（SUV）的中位数及范围。
结果
对35例患者（中位年龄57岁[四分位间距]，51 - 65岁）进行了评估。在未经治疗的患者（n = 27）中，与F-FDG PET/CT相比，Ga-FAPI PET/CT使5例（19%）患者的临床TNM分期上调。对于原发性病变，F-FDG和Ga-FAPI之间在示踪剂摄取方面未观察到显著差异：乳腺癌（7.2对4.9，P = 0.086）、卵巢癌（16.3对15.7，P = 0.345）和宫颈癌（18.3对17.1，P = 0.703）。对于受累淋巴结，Ga-FAPI PET/CT显示乳腺癌（9.9对6.1，P = 0.007）和宫颈癌（6.3对4.8，P = 0.048）的SUV更高，而卵巢癌未观察到显著差异（7.0对5.9，P = 0.179）。此外，与F-FDG PET/CT相比，Ga-FAPI PET/CT在检测转移性淋巴结方面显示出更高的特异性和准确性（100%对66%，P < 0.001；94%对80%，P < 0.001）。相比之下，敏感性无显著差异（97%对86%，P = 0.125）。对于大多数远处转移，Ga-FAPI在骨转移中显示出比F-FDG更高的SUV（12.9对4.9，P = 0.036）。
结论
Ga-FAPI PET/CT在检测常见妇科恶性肿瘤患者的原发性和转移性病变方面显示出更高的示踪剂摄取，优于F-FDG PET/CT。
试验注册
中国临床试验注册中心，ChiCTR2100044131。于2022年10月10日注册，https://www.chictr.org.cn ，ChiCTR2100044131
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