Comparison of the diagnostic efficacy of 68Ga-FAPI-04 PET/MR and 18F-FDG PET/CT in patients with pancreatic cancer
Comparison of the diagnostic efficacy of 68Ga-FAPI-04 PET/MR and 18F-FDG PET/CT in patients with pancreatic cancer
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68Ga-FAPI-04 PET/MR与 18F-FDG PET/CT对胰腺癌诊断效果比较
DOI：
10.1007/s00259-022-05729-5
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发表时间：
2022-03-04
影响因子：
9.1
通讯作者：
Zuo, Changjing
中科院分区：
文献类型：
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作者：
Zhang, Zeyu;Jia, Guorong;Zuo, Changjing
目的：我们旨在评估镓 - 68（⁶⁸Ga）-FAPI - 04正电子发射断层显像/磁共振成像（PET/MR）对胰腺癌患者原发性肿瘤以及转移性病变的诊断效能，并将结果与氟 - 18（¹⁸F）-氟脱氧葡萄糖（FDG）PET/CT进行比较。
方法：前瞻性地评估了33例疑似胰腺腺癌的患者，其中32例经组织病理学证实，1例经穿刺活检和糖皮质激素治疗证实为自身免疫性胰腺炎。在1周内，每位患者均接受了⁶⁸Ga - FAPI - 04 PET/MR和¹⁸F - FDG PET/CT检查。对这两种成像方法检测原发性肿瘤、淋巴结和转移灶的能力进行了比较。测量并比较了⁶⁸Ga - FAPI - 04 PET/MR和¹⁸F - FDG PET/CT上成对病变的原始最大标准摄取值（SUVmax）和标准化SUVmax（SUVmax/SUVbkgd）。
结果：纳入了30例胰腺癌患者和3例胰腺炎患者。⁶⁸Ga - FAPI - 04 PET/MR和¹⁸F - FDG PET/CT对原发性肿瘤的检出率相同（100%）。⁶⁸Ga - FAPI - 04 PET上原发性肿瘤的原始/标准化SUVmax明显高于¹⁸F - FDG（p < 0.05）。16例胰腺癌患者有胰腺实质摄取，而¹⁸F - FDG PET图像仅4例患者显示实质摄取（53.33%对13.33%，p < 0.001）。⁶⁸Ga - FAPI - 04 PET检测到的阳性淋巴结多于¹⁸F - FDG PET（42个对30个，p < 0.001），而¹⁸F - FDG PET能够检测到比⁶⁸Ga - FAPI - 04更多的肝转移灶（181个对104个，p < 0.001）。此外，多序列MR成像有助于解释因⁶⁸Ga - FAPI - 04炎症摄取而无法明确显示的10例胰腺癌，并比¹⁸F - FDG检测到更多的肝转移灶（256个对181个，p < 0.001）。
结论：⁶⁸Ga - FAPI - 04 PET在检测可疑淋巴结转移方面可能优于¹⁸F - FDG PET。⁶⁸Ga - FAPI - 04 PET/MR的MR多序列成像有助于解释梗阻性炎症患者的胰腺病变以及检测微小肝转移灶。
Purpose We sought to assess the performance of (68) Ga-FAPI-04 PET/MR for the diagnosis of primary tumours as well as metastatic lesions in patients with pancreatic cancer and to compare the results with those of F-18-FDG PET/CT.Methods Prospectively, we evaluated 33 patients suspected to have pancreatic adenocarcinoma, of whom thirty-two were confirmed by histopathology, and one had autoimmune pancreatitis confirmed by needle biopsy and glucocorticoid treatment. Within 1 week, each patient underwent both (68) Ga-FAPI-04 PET/MR and F-18-FDG PET/CT. Comparisons of the detection abilities for primary tumours, lymph nodes, and metastases were conducted for the two imaging approaches. The original maximum standard uptake values (SUVmax) and normalised SUVmax (SUVmax/SUVbkgd) of paired lesions on (68) Ga-FAPI-04 PET/MR and F-18-FDG PET/CT were measured and compared.Results Thirty pancreatic cancer patients and three pancreatitis patients were enrolled. (68) Ga-FAPI-04 PET/MR and F-18-FDG PET/CT exhibited equivalent (100%) detection rates for primary tumours. The original/normalised SUVmax of primary tumours on (68) Ga-FAPI-04 PET was markedly higher than that on F-18-FDG (p < 0.05). Sixteen pancreatic cancer patients had pancreatic parenchymal uptake, whereas F-18-FDG PET images showed parenchymal uptake in only four patients (53.33% vs. 13.33%, p < 0.001). (68) Ga-FAPI-04 PET detected more positive lymph nodes than F-18-FDG PET (42 vs. 30, p < 0.001), while F-18-FDG PET was able to detect more liver metastases than (68) Ga-FAPI-04 (181 vs. 104, p < 0.001). In addition, multisequence MR imaging helped explain ten pancreatic cancers that could not be definitively revealed due to (68) Ga-FAPI-04 inflammatory uptake and identified more liver metastases than F-18-FDG (256 vs. 181, p < 0.001).Conclusion (68) Ga-FAPI-04 PET might be better than F-18-FDG PET in the detection of suspicious lymph node metastases. MR multiple sequence imaging of (68) Ga-FAPI-04 PET/MR was helpful for explaining pancreatic lesions in patients with obstructive inflammation and detecting tiny liver metastases.