高级检索

    放射性核素药物18F-FAPI与18F-FDG在胃癌、结直肠癌术后转移灶PET/CT显像中的应用比较

    Comparison of Application of Radiopharmaceutical 18F-FAPI and 18F-FDG in PET/CT Imaging for Postoperative Metastatic Lesions of Gastric Cancer and Colorectal Cancer

      摘要
    • 摘要:
      目的  比较18F-FAPI-04与18F-FDG 2种不同的PET核素药物在胃癌、结直肠癌术后转移灶中的应用价值。
      方法 前瞻性纳入22例胃癌、结直肠癌术后患者(2023年5月至2024年3月，男性16例，女性6例，年龄49~71岁)，每例患者均在1周内行18F-FAPI-04 PET/CT和18F-FDG PET/CT检查，最终对获得的临床及影像资料进行分析。以病灶的手术或穿刺活检组织的病理结果作为诊断的金标准，其余未能行组织病理学诊断的患者，则以实验室检查、影像学检查、随访结果及临床综合判断作为诊断的参考标准。采用Wilcoxon signed-rank test分析比较18F-FAPI-04与18F-FDG在胃癌、结直肠癌术后转移灶PET/CT显像中最大标准摄取值(SUVmax)、靶本底比值(target to background ratio，TBR)，采用McNemar检验比较18F-FAPI-04与18F-FDG在胃癌、结直肠癌术后转移灶PET/CT显像中的检出率。
      结果 与18F-FDG在转移灶的SUVmax相比，18F-FAPI-04在腹膜转移灶6.9(4.4，8.0)与1.9(1.0，2.7)，z=−5.580，P<0.001和淋巴结转移灶6.2(4.5，5.3)与 5.2(3.1，10.7)，z=−2.170，P=0.03中的SUVmax明显较高，而在肝转移灶7.8(5.3，9.0)与 8.1(5.3，10.8)，z=−1.57，P=0.875和骨转移灶6.2(3.7，8.2)与5.2(3.0，7.9)，z=−1.244，P=0.214中的SUVmax差异无统计学意义。与18F-FDG PET/CT图像中转移灶的TBR相比较，18F-FAPI-04 PET/CT中的腹膜转移灶5.4(3.4，6.4)与1.2(0.7，1.7)，z=−5.580，P<0.001、淋巴结转移灶5.4(2.8，7.2)与3.9(2.5，5.2)，z=−4.698，P<0.001、肝转移灶6.3(2.5，9.4) 与 3.3(2.0，3.9)，z=−2.312，P=0.021和骨转移灶7.6(3.6，10.2) 与 4.3(2.9，5.9)，z=−2.194，P=0.028的TBR明显较高。此外，相比18F-FDG对转移病灶的检出率，18F-FAPI-04对腹膜转移100%(41/41)与26.8%(11/41)，P<0.001和淋巴结转移92.6%(50/54)与77.8%(42/54)，P=0.021的检出率明显较高，而对肝转移100%(9/9)与100%(9/9)和骨转移 100%(12/12)与 100%(12/12) 的检出率差异无统计学意义。
      结论 18F-FAPI-04对于胃癌、结直肠癌术后患者在淋巴结转移、腹膜转移PET/CT显像中的表现优于18F-FDG，18F-FAPI-04在胃癌、结直肠癌术后患者再分期中具有优势，有助于制定临床决策。

       

      Abstract:
      OBJECTIVE  To compare the application value of two different PET radiopharmaceutical: 18F-FAPI-04 and 18F-FDG, in postoperative metastatic lesions of gastric cancer and colorectal cancer.
      METHODS  A prospective study enrolled 22 postoperative patients with gastric cancer and colorectal cancer(16 males and 6 females, aged 49−71 years) between May 2023 and March 2024. Each patient underwent both 18F-FAPI-04 PET/CT and 18F-FDG PET/CT within one week. Subsequently, clinical and imaging data were analyzed. The pathological results of surgical or needle biopsy specimens from the lesions served as the gold standard for diagnosis. For patients who did not undergo histopathological examination, the diagnostic reference standard included laboratory tests, imaging findings, follow-up results, and clinical comprehensive evaluations. To compare the maximum standard uptake value(SUVmax) and target to background ratios(TBR) of 18F-FAPI-04 and 18F-FDG PET/CT imaging in postoperative metastatic lesions of gastric cancer and colorectal cancer by using the Wilcoxon signed-rank test. Additionally, the McNemar test was utilized to compare the detection rates of 18F-FAPI-04 and 18F-FDG in PET/CT imaging of postoperative metastases of gastric cancer and colorectal cancer.
      RESULTS  Compared with the SUVmax of 18F-FDG in metastatic lesions, the SUVmax of 18F-FAPI-04 in peritoneal metastasis lesions6.9(4.4, 8.0) vs 1.9(1.0, 2.7), z=−5.580; P<0.001) and metastasis lymph nodes6.2(4.5, 5.3) vs 5.2(3.1, 10.7), z=−2.170, P=0.03 were significantly higher, while difference of SUVmax in liver metastatic lesions7.8(5.3, 9.0) vs 8.1(5.3, 10.8), z=−1.57, P=0.875), and bone metastatic lesions6.2(3.7, 8.2) vs 5.2(3.0, 7.9), z=−1.244, P=0.214 had no statistical difference. Compared with the TBR of metastatic foci in 18F-FDG PET/CT images, in 18F-FAPI-04 PET/CT images, the TBR of peritoneal metastatic lesions5.4(3.4, 6.4) vs 1.2(0.7, 1.7), z=−5.580, P<0.001, metastasis lymph nodes5.4(2.8, 7.2) vs 3.9(2.5, 5.2), z=−4.698, P<0.001), liver metastatic lesions6.3(2.5, 9.4) vs 3.3(2.0, 3.9), z=−2.312, P=0.021), and bone metastatic lesions7.6(3.6, 10.2) vs 4.3(2.9, 5.9), z=−2.194, P=0.028) were significantly higher. In addition, compared with 18F-FDG, 18F-FAPI-04 had a higher detection rate of peritoneal metastasis100%(41/41) vs 26.8%(11/41), P<0.001 and lymph node metastasis92.6%(50/54) vs 77.8%(42/54), P<0.021, but there was no significant difference in the detection rate of liver metastasis100%(9/9) vs 100%(9/9) and bone metastasis100%(12/12) vs 100%(12/12).
      CONCLUSION  18F-FAPI-04 has better performance than 18F-FDG in PET/CT imaging of lymph node metastasis and peritoneal metastasis in postoperative patients with gastric cancer and colorectal cancer, and 18F-FAPI-04 has advantages in the restaging of postoperative patients with gastric cancer and colorectal cancer, which is helpful for making clinical decisions.

       

      • HTML全文
      • 参考文献(20)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回