Characteristics of 18F-FAPI-04 PET/CT in patients with peritoneal metastasis and to predict treatment efficacy, a head-to-head comparison with 18F-FDG PET/CT

被引:0
作者
Zhang, Yafei [1 ]
Xu, Mimi [1 ]
Wang, Yu [2 ]
Yu, Fang [3 ]
Chen, Xinxin [1 ]
Wang, Guangfa [1 ]
Zhao, Kui [1 ]
Yang, Hong [4 ]
Su, Xinhui [1 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 1, Dept Nucl Med, Sch Med, 79 Qingchun Rd, Hangzhou 310003, Peoples R China
[2] Chinese Med Univ, Affiliated Hosp Zhejiang 2, Dept Pharm, Hangzhou 310005, Peoples R China
[3] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Pathol, Hangzhou 310003, Peoples R China
[4] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Radiol, 79 Qingchun Rd, Hangzhou 310003, Peoples R China
关键词
Peritoneal metastases; Fibroblast activation protein; F-18-FAPI-04; PET/CT; FIBROBLAST ACTIVATION PROTEIN; STROMAL FIBROBLASTS; COLORECTAL-CANCER; ADENOCARCINOMA; CARCINOMATOSIS; RISK;
D O I
10.1186/s40644-025-00887-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background F-18-FAPI-04 PET/CT shows promise in detecting peritoneal metastases (PM), but its superiority over F-18-FDG PET/CT for lesion detection and predicting chemotherapy benefit remains unclear. Purpose To compare F-18-FAPI-04 and F-18-FDG PET/CT imaging features in PM and assess predictive value of F-18-FAPI-04 for chemotherapy efficacy. Methods 39 pathologically confirmed PM patients with digestive malignancies underwent concurrent F-18-FAPI-04 and F-18-FDG PET/CT. Semi-quantitative parameters, including SUVmax, tumor/liver ratio (T/L), tumor/mediastinal blood pool ratio (T/B), were analyzed. The tracer uptake was compared via Wilcoxon tests. The relationships between F-18-FAPI-04 uptake with FAP and alpha-SMA expression were analyzed using Pearson correlation. Patients were divided into different short-term outcome groups (responders vs. non-responders) according to RECIST criteria (v.1.1) after chemotherapy. Post-chemotherapy outcomes were evaluated using logistic regression. Results Patients (median age 62; 16 females, 23 males) included pancreatic (n = 17), cholangiocarcinoma (n = 8), gastric (n = 6), and colorectal cancers (n = 8). F-18-FAPI-04 demonstrated significantly higher SUVmax, T/L, and T/B than F-18-FDG (P < 0.05). Pancreaticobiliary cancers (pancreatic/cholangiocarcinoma) exhibited higher 18F-FAPI-04 uptake than gastroenteric cancers (gastric/colorectal) (P < 0.05), though no differences existed within subgroups. F-18-FAPI-04 parameters positively correlated with FAP and alpha-SMA expression. In univariate analysis, F-18-FAPI-04 uptake differed significantly between responders and non-responders. Multivariate analysis identified SUVmax as an independent predictor (OR = 1.354, 95%CI:1.025-1.788, P = 0.033). Optimal F-18-FAPI-04 cut-offs for distinguishing outcomes were SUVmax=11.05 (AUC = 0.783; sensitivity = 70.60%, specificity = 80.40%), T/L = 7.53 (AUC = 0.717; 58.82%, 81.82%), and T/B = 8.76 (AUC = 0.751; 64.71%, 86.37%). Conclusion F-18-FAPI-04 PET/CT outperforms F-18-FDG in PM detection, with semi-quantitative parameters predicting chemotherapy response.
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页数:12
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