Higher accuracy of [68 Ga]Ga-DOTA-FAPI-04 PET/CT comparing with 2-[18F]FDG PET/CT in clinical staging of NSCLC
Higher accuracy of [68 Ga]Ga-DOTA-FAPI-04 PET/CT comparing with 2-[18F]FDG PET/CT in clinical staging of NSCLC
复制标题
与 2-[18F]FDG PET/CT 相比，[68Ga]Ga-DOTA-FAPI-04 PET/CT 在 NSCLC 临床分期中的准确性更高
DOI：
10.1007/s00259-022-05818-5
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发表时间：
2022-05-11
影响因子：
9.1
通讯作者：
Li, Nan
中科院分区：
文献类型：
--
作者：
Zhou, Xin;Wang, Shuailiang;Li, Nan
目的探讨68 Ga DOTA FAPI 04 PET/CT显像与2-[F 18]FDG PET/CT显像对非小细胞肺癌（NSCLC）的临床分期价值。方法前瞻性研究ChiCTR 2000038080，共纳入134例确诊或疑似NSCLC患者，均行2-[F-18]FDG PET/CT和[（68）Ga]Ga-DOTA-FAPI-04 PET/CT检查。其中，对74例NSCLC患者的原发肿瘤（T）诊断、淋巴结（N）和转移灶（M）分期进行了回顾性分析。比较2-[F-18]FDG PET/CT和[（68）Ga]Ga-DOTA-FAPI-04 PET/CT对肺结节和疑似转移瘤的分期性能。结果在72例患者的79个肺结节中，[68] Ga DOTA FAPI 04的T诊断性能优于2-[F 18]FDG，尤其是对非实性和小直径腺癌结节的T诊断。对于N分期，分析了37例患者的98个淋巴结（LN）的病理结果。[（68）Ga]Ga-DOTA-FAPI-04在非转移性LN中的SUVmax显著低于转移性LN中的SUVmax。关于转移性LN的识别，计算的[（68）Ga]Ga-DOTA-FAPI-04 SUVmax的最佳截止值为5.5，使用[（68）Ga]Ga-DOTA-FAPI-04和2-[F-18]FDG标准的诊断准确性分别为94%和30%（P < 0.001）。对于M分期，[（68）Ga]Ga-DOTA-FAPI-04比2-[F-18]FDG在14例多发性转移患者中识别出更多病变（257 vs. 139个病变）。总体而言，在52例不同病理分期的患者中，[（68）Ga]Ga-DOTA-FAPI-04的分期准确性优于2-[F-18]FDG [43/52（82.7%）vs. 27/52（51.9%），P = 0.001]。结论与2-[F-18]FDG PET/CT相比，[（68）Ga]Ga-DOTA-FAPI-04 PET/CT对不同病理分期的NSCLC患者，尤其是局限性病变的NSCLC患者，具有更好的分期效果。
Purpose This study aimed to explore the clinical staging performance of [(68) Ga]Ga-DOTA-FAPI-04 PET/CT compared with that of 2-[F-18]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-18]FDG PET/CT and [(68) 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-18]FDG PET/CT and [(68) Ga]Ga-DOTA-FAPI-04 PET/CT was compared. Results For T diagnosis, [(68) Ga]Ga-DOTA-FAPI-04 showed better diagnostic performance than 2-[F-18]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 SUVmax of [(68) 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 [(68) Ga]Ga-DOTA-FAPI-04 SUVmax was 5.5, and the diagnostic accuracy using [(68) Ga]Ga-DOTA-FAPI-04 and 2-[F-18]FDG criteria was 94% and 30%, respectively (P < 0.001). For M staging, [(68) Ga]Ga-DOTA-FAPI-04 identified more lesions than 2-[F-18]FDG (257 vs. 139 lesions) in 14 patients with multiple metastases. Overall, the staging accuracy of [(68) Ga]Ga-DOTA-FAPI-04 was better than that of 2-[F-18]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-18]FDG PET/CT, [(68) Ga]Ga-DOTA-FAPI-04 PET/CT demonstrated better staging performance in NSCLC patients with different pathological stages, especially those with localized disease.