Role of [18F]FAPI-04 in staging and therapeutic management of intrahepatic cholangiocarcinoma: prospective comparison with [18F]FDG PET/CT

被引：2

作者：

Liang, Jiucen ^{[1
,2
]}

Jiang, Shuqin ^{[1
,2
]}

Song, Jingjing ^{[2
,3
]}

Chen, Danyang ^{[2
,4
]}

Weng, Shaojuan ^{[2
,4
]}

Li, Shuyi ^{[1
,2
]}

Peng, Hao ^{[1
,2
]}

Liu, Zhidong ^{[1
,2
]}

Zhang, Jing ^{[1
,2
]}

Chen, Yuanlin ^{[2
,3
]}

Rao, Songquan ^{[1
,2
]}

Chen, Haipeng ^{[1
,2
]}

Zhang, Rusen ^{[1
,2
]}

Liu, Hao ^{[2
,4
]}

Zhang, Linqi ^{[1
,2
]}

机构：

[1] Affiliated Canc Hosp, Dept Nucl Med, 78 Hengzhigang Rd, Guangzhou 510095, Guangdong, Peoples R China

[2] Inst Guangzhou Med Univ, 78 Hengzhigang Rd, Guangzhou 510095, Guangdong, Peoples R China

[3] Affiliated Canc Hosp, Dept Pathol, 78 Hengzhigang Rd, Guangzhou 510095, Guangdong, Peoples R China

[4] Affiliated Canc Hosp, Tumor Res Inst, 78 Hengzhigang Rd, Guangzhou 510095, Guangdong, Peoples R China

来源：

EJNMMI RESEARCH | 2024年 / 14卷 / 01期

基金：

中国国家自然科学基金;

关键词：

F-18]FAPI-04; F-18]FDG; PET/CT; Intrahepatic cholangiocarcinoma; Cancer-associated fibroblasts; POSITRON-EMISSION-TOMOGRAPHY; DIAGNOSIS; CANCER;

D O I：

10.1186/s13550-024-01145-y

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background Fluorine-18 fluorodeoxyglucose ([F-18]FDG) positron emission tomography/computed tomography (PET/CT) has some limitations in diagnosis of Intrahepatic cholangiocarcinoma (ICC). Materials and methods Patients with histologically confirmed ICC who underwent both [F-18]FDG and F-18-labeled fibroblast-activation protein inhibitors ([F-18]FAPI)-04 PET/CT were prospectively analyzed. The maximum standard uptake value (SUVmax), tumor-to-background ratio (TBR), metabolic tumor volume (MTV), total lesion glycolysis (TLG), [F-18]FAPI-avid tumor volume (FTV), total lesion fibroblast activation protein expression (TLF) were compared between the two modalities by paired Wilcoxon signed-rank test and Mann-Whitney U test, and McNemar's test was used to assess the diagnostic accuracy between the two techniques. Results In total, 23 patients with 389 lesions were included. Compared to [F-18]FDG, [F-18]F-FAPI-04 PET/CT demonstrated a higher detection rate for intrahepatic lesions (86.3% vs. 78.2% P = 0.040), lymph node metastases (85.2% vs. 68.2%, P = 0.007), peritoneal metastases (100% vs. 93.8%), and bone metastases (100% vs. 70.5%, P < 0.001). [F-18]FAPI-04 PET showed higher SUVmax, TBR and greater tumor burden values than [F-18]FDG PET in non-cholangitis intrahepatic lesions (SUVmax: 8.7 vs. 6.4, P < 0.001; TBR: 8.0 vs. 3.5, P < 0.001; FTV vs. MTV: 41.3 vs. 12.4, P < 0.001; TLF vs. TLG: 223.5 vs. 57.0, P < 0.001), lymph node metastases (SUVmax: 6.5 vs. 5.5, P = 0.042; TBR: 5.4 vs. 3.9, P < 0.001; FTV vs. MTV: 2.0 vs. 1.5, P = 0.026; TLF vs. TLG: 9.0 vs. 7.8 P = 0.024), and bone metastases (SUVmax: 9.7 vs. 5.25, P < 0.001; TBR: 10.8 vs. 3.0, P < 0.001; TLF vs. TLG: 9.8 vs. 4.2, P < 0.001). However, [F-18]FDG showed higher radiotracer uptake (SUVmax: 14.7 vs. 8.4, P < 0.001; TBR: 7.4 vs. 2.8, P < 0.001) than [F-18]FAPI-04 PET/CT for 6 patients with obstructive cholangitis. [F-18]FAPI-04 PET/CT yielded a change in planned therapy in 6 of 23 (26.1%) patients compared with [F-18]FDG. Conclusions [18F]FAPI-04 PET/CT had higher detection rate and radiotracer uptake than [18F]FDG PET/CT in intrahepatic lesions, lymph node metastases, and distant metastases, especially in bone. Therefore, [F-18]FAPI-04 PET/CT may be a promising technique for diagnosis and staging of ICC. Trial registrationClinical Trials, NCT05485792. Registered 1 August 2022, retrospectively registered, https//clinicaltrials.gov/study/NCT05485792?cond=NCT05485792&rank=1.

引用

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