目的研究Al^(18)F-1,4,7-三氮杂环壬烷-1,4,7-三乙酸(NOTA)-成纤维细胞激活蛋白抑制剂(FAPI)-04 PET/CT显像非肿瘤摄取的分布特征,并探讨其生物学意义。方法回顾性横断面研究。连续纳入2022年12月至2023年8月期间在江南大学附属医院接受...目的研究Al^(18)F-1,4,7-三氮杂环壬烷-1,4,7-三乙酸(NOTA)-成纤维细胞激活蛋白抑制剂(FAPI)-04 PET/CT显像非肿瘤摄取的分布特征,并探讨其生物学意义。方法回顾性横断面研究。连续纳入2022年12月至2023年8月期间在江南大学附属医院接受Al^(18)F-NOTA-FAPI-04 PET/CT检查的90例肿瘤或高度疑似肿瘤患者[男55例、女35例,年龄(63.3±9.7)岁]的PET/CT图像和临床资料。采用SUV max评估全身非肿瘤灶(正常器官和良性病变)摄取水平和分布特征,组间比较采用Mann-Whitney U检验。结果正常器官存在不同程度的生理性摄取特征,其中下颌下腺、胆道系统和子宫呈明显摄取(SUV max 5.0~9.0);腭扁桃体、甲状腺和胰腺呈中度摄取(SUV max 3.0~5.0);腮腺、左心室壁、肝、脾、肾、肌肉、前列腺呈轻度摄取(SUV max 1.6~3.0)。甲状腺炎组(7例)甲状腺摄取高于甲状腺功能正常组(17例)[4.95(2.61,9.20)和2.80(2.25,3.41);Z=-2.06,P=0.040],肝实质损伤组(7例)肝脏摄取高于无实质损伤组(49例)[3.11±0.88和1.88(1.34,3.22);Z=-1.97,P=0.049]。结论在Al^(18)F-NOTA-FAPI-04 PET/CT显像中,正常器官存在不同程度的生理性摄取特征。甲状腺炎、肝实质损伤等良性病变可能会影响摄取程度,需结合临床信息综合判断。展开更多
Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of...Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor(^(18)F-FAPI-42)and fluorine-18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)for detecting PM of colorectal cancer and to guide clinical decision-making.Methods:Forty-eight patients with PM who underwent both^(18)F-FAPI-42 and^(18)F-FDG PET/CT examinations were studied.The maximum standardized uptake value(SUV max),tumor-to-background ratios(TBRs)and peritoneal cancer index(PCI)of the PM were compared between the two imaging techniques.The intraclass correlation coefficient(ICC)was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI.A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction(complete cytoreduction with no visible disease).Results:The sensitivity and accuracy of^(18)F-FAPI-42 PET/CT for detecting PM were higher than those of^(18)F-FDG PET/CT(82.1%vs 61.1%,P<0.01;84.6%vs 74.5%,P<0.01).The median SUV max and TBR of PM was greater in^(18)F-FAPI-42 than in^(18)F-FDG PET/CT[4.8(1.9-20.1)vs 4.7(1.0-11.0),P=0.02;4.3(1.4-14.6)vs 2.9(0.6-8.0),P<0.01,respectively].The median PCI of PM based on^(18)F-FAPI-42 PET/CT was greater than that based on^(18)F-FDG PET/CT(15 vs 9,P<0.01).The ICC for^(18)F-FAPI-42 PCI was greater than that for^(18)F-FDG PCI(0.915 vs 0.724,P<0.01).The cut-off values of the PCI of the PM for^(18)F-FAPI-42 and^(18)F-FDG PET/CT to predict CC-0 were<18 and<10,with areas under the curve of 0.80 and 0.79,respectively.Conclusions:^(18)F-FAPI-42 PET/CT has superior diagnostic efficacy for PM,particularly in the right upper epigastrium and small intestine.The PCI score of^(18)F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0.The individualized management of PM based on the^(18)F-FAPI-42 PET/CT PCI score is pivotal.展开更多
文摘目的研究Al^(18)F-1,4,7-三氮杂环壬烷-1,4,7-三乙酸(NOTA)-成纤维细胞激活蛋白抑制剂(FAPI)-04 PET/CT显像非肿瘤摄取的分布特征,并探讨其生物学意义。方法回顾性横断面研究。连续纳入2022年12月至2023年8月期间在江南大学附属医院接受Al^(18)F-NOTA-FAPI-04 PET/CT检查的90例肿瘤或高度疑似肿瘤患者[男55例、女35例,年龄(63.3±9.7)岁]的PET/CT图像和临床资料。采用SUV max评估全身非肿瘤灶(正常器官和良性病变)摄取水平和分布特征,组间比较采用Mann-Whitney U检验。结果正常器官存在不同程度的生理性摄取特征,其中下颌下腺、胆道系统和子宫呈明显摄取(SUV max 5.0~9.0);腭扁桃体、甲状腺和胰腺呈中度摄取(SUV max 3.0~5.0);腮腺、左心室壁、肝、脾、肾、肌肉、前列腺呈轻度摄取(SUV max 1.6~3.0)。甲状腺炎组(7例)甲状腺摄取高于甲状腺功能正常组(17例)[4.95(2.61,9.20)和2.80(2.25,3.41);Z=-2.06,P=0.040],肝实质损伤组(7例)肝脏摄取高于无实质损伤组(49例)[3.11±0.88和1.88(1.34,3.22);Z=-1.97,P=0.049]。结论在Al^(18)F-NOTA-FAPI-04 PET/CT显像中,正常器官存在不同程度的生理性摄取特征。甲状腺炎、肝实质损伤等良性病变可能会影响摄取程度,需结合临床信息综合判断。
基金the National Natural Science Foundation of China[grant no.82103084]the Dongguan Science and Technology of Social Development Program[grant no.20231800904303]+6 种基金Z.Z.has received grants from the National Natural Science Foundation of China[no.81901772]the Natural Science Foundation of Guangdong Province[nos 2019A1515011893,2023A1515011300]the State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia&The First People’s Hospital of Kashi Fund[no.SKL-HIDCA-2020-KS2]H.W.has received grants from the Xinjiang Autonomous Region Technology Plan[grant no.2022E02125]The Sixth Affiliated Hospital of Sun Yat-Sen University Clinical Research-1010 Program:1010CG(2022)-08K.Y.has received grants from the National Natural Science Foundation of China[grant no.82300619]the Science and Technology Projects in Guangzhou[grant no.2023A04J2245].
文摘Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor(^(18)F-FAPI-42)and fluorine-18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)for detecting PM of colorectal cancer and to guide clinical decision-making.Methods:Forty-eight patients with PM who underwent both^(18)F-FAPI-42 and^(18)F-FDG PET/CT examinations were studied.The maximum standardized uptake value(SUV max),tumor-to-background ratios(TBRs)and peritoneal cancer index(PCI)of the PM were compared between the two imaging techniques.The intraclass correlation coefficient(ICC)was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI.A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction(complete cytoreduction with no visible disease).Results:The sensitivity and accuracy of^(18)F-FAPI-42 PET/CT for detecting PM were higher than those of^(18)F-FDG PET/CT(82.1%vs 61.1%,P<0.01;84.6%vs 74.5%,P<0.01).The median SUV max and TBR of PM was greater in^(18)F-FAPI-42 than in^(18)F-FDG PET/CT[4.8(1.9-20.1)vs 4.7(1.0-11.0),P=0.02;4.3(1.4-14.6)vs 2.9(0.6-8.0),P<0.01,respectively].The median PCI of PM based on^(18)F-FAPI-42 PET/CT was greater than that based on^(18)F-FDG PET/CT(15 vs 9,P<0.01).The ICC for^(18)F-FAPI-42 PCI was greater than that for^(18)F-FDG PCI(0.915 vs 0.724,P<0.01).The cut-off values of the PCI of the PM for^(18)F-FAPI-42 and^(18)F-FDG PET/CT to predict CC-0 were<18 and<10,with areas under the curve of 0.80 and 0.79,respectively.Conclusions:^(18)F-FAPI-42 PET/CT has superior diagnostic efficacy for PM,particularly in the right upper epigastrium and small intestine.The PCI score of^(18)F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0.The individualized management of PM based on the^(18)F-FAPI-42 PET/CT PCI score is pivotal.
