Fibroblast Activation Protein and Glycolysis in Lymphoma Diagnosis: Comparison of 68Ga-FAPI PET/CT and 18F-FDG PET/CT

被引：22
作者：
Chen, Xuetao [1 ]
Wang, Shuailiang [1 ]
Lai, Yumei [2 ]
Wang, Guochang [1 ]
Wei, Maomao [1 ]
Jin, Xiao [1 ]
Ding, Jin [1 ]
Zhang, Yan [1 ]
Shi, Yunfei [2 ]
Wang, Feng [1 ]
Zhu, Hua [1 ]
Yang, Zhi [1 ]
Wang, Xuejuan [1 ]
机构：
[1] Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing,Natl Med Prod Assoc, Natl Med Prod Assoc,Dept Nucl Med,Key Lab Res & E, Beijing, Peoples R China
[2] Peking Univ Canc Hosp & Inst, Dept Pathol, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing, Beijing, Peoples R China
来源：
JOURNAL OF NUCLEAR MEDICINE | 2023年 / 64卷 / 09期
基金：
中国国家自然科学基金;
关键词：
Ga-68-FAPI PET; F-18-FDG PET; lymphoma; fibroblast activation protein; glycolysis; NON-HODGKIN-LYMPHOMA; TUMOR MICROENVIRONMENT;
D O I：
10.2967/jnumed.123.265530
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：
Our objective was to compare the diagnostic performance of Ga-68-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and F-18-labeled FDG PET/CT in diagnosing lymphomas and to characterize the influence of FAP and glycolytic markers on tracer uptake by involved lesions. Methods: Participants with different lymphoma subtypes who were pro-spectively recruited from May 2020 to December 2021 underwent Ga-68-FAPI and F-18-FDG PET/CT. Immunohistochemistry was performed to evaluate FAP, hexokinase 2, and glucose transporter 1 (GLUT1) expres-sion, and the paired-samples t test and Wilcoxon signed-rank test were used to compare parameters. The correlation between the immuno-chemistry results and tracer uptake was determined by the Spearman rank correlation coefficient. Results: In total, 186 participants (median age, 52 y [interquartile range, 41-64 y]; 95 women) were included. Dual -tracer imaging produced 3 types of imaging profiles. F-18-FDG PET pos-sessed a higher staging accuracy (98.4%) than 68Ga-FAPI PET (86.0%). In 5,980 lymphoma lesions, F-18-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than 68Ga-FAPI PET/CT. Additionally, 52 Ga-68-FAPI-positive/F-18-FDG-negative lesions and 2,939 Ga-68-FAPI-negative/F-18-FDG-positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUVmax or target-to-liver ratios between Ga-68-FAPI and F-18-FDG PET/CT (P . 0.05). Interestingly, GLUT1 and hexoki-nase 2 were overexpressed both in lymphoma cells and in the tumor microenvironment, whereas FAP was expressed only in stromal cells. FAP and GLUT1 expression correlated positively with Ga-68-FAPI SUVmax (r = 0.622, P = 0.001) and F-18-FDG SUVmax (r = 0.835, P , 0.001), respectively. Conclusion: Ga-68-FAPI PET/CT was inferior to F-18-FDG PET/CT in diagnosing lymphomas with low FAP expression. However, the former may supplement the latter and help reveal the molecular pro-file of lymphomas.
引用
收藏
页码：1399 / 1405
页数：7
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