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

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-09-11 DOI:10.1186/s13550-024-01145-y

Jiucen Liang, Shuqin Jiang, Jingjing Song, Danyang Chen, Shaojuan Weng, Shuyi Li, Hao Peng, Zhidong Liu, Jing Zhang, Yuanlin Chen, Songquan Rao, Haipeng Chen, Rusen Zhang, Hao Liu, Linqi Zhang

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引用次数: 0

Abstract

Fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has some limitations in diagnosis of Intrahepatic cholangiocarcinoma (ICC). Patients with histologically confirmed ICC who underwent both [18F]FDG and 18F-labeled fibroblast-activation protein inhibitors ([18F]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), [18F]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. In total, 23 patients with 389 lesions were included. Compared to [18F]FDG, [18F]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). [18F]FAPI-04 PET showed higher SUVmax, TBR and greater tumor burden values than [18F]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, [18F]FDG showed higher radiotracer uptake (SUVmax: 14.7 vs. 8.4, P < 0.001; TBR: 7.4 vs. 2.8, P < 0.001) than [18F]FAPI-04 PET/CT for 6 patients with obstructive cholangitis. [18F]FAPI-04 PET/CT yielded a change in planned therapy in 6 of 23 (26.1%) patients compared with [18F]FDG. [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, [18F]FAPI-04 PET/CT may be a promising technique for diagnosis and staging of ICC. Clinical Trials, NCT05485792. Registered 1 August 2022, retrospectively registered, https//clinicaltrials.gov/study/NCT05485792?cond=NCT05485792&rank=1.

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18F]FAPI-04 在肝内胆管癌分期和治疗管理中的作用：与 [18F]FDG PET/CT 的前瞻性比较

氟-18脱氧葡萄糖（[18F]FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在诊断肝内胆管癌（ICC）方面存在一些局限性。我们对同时接受[18F]FDG和18F标记成纤维细胞活化蛋白抑制剂（[18F]FAPI）-04 PET/CT检查的组织学确诊ICC患者进行了前瞻性分析。通过配对 Wilcoxon 符号秩检验和 Mann-Whitney U 检验比较了两种方法的最大标准摄取值（SUVmax）、肿瘤与背景比（TBR）、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）、[18F]FAPI-avid 肿瘤体积（FTV）、总病灶成纤维细胞活化蛋白表达（TLF），并用 McNemar 检验评估了两种技术的诊断准确性。共纳入了 23 名患者的 389 个病灶。与[18F]FDG相比，[18F]F-FAPI-04 PET/CT对肝内病变（86.3% 对 78.2%，P = 0.040）、淋巴结转移（85.2% 对 68.2%，P = 0.007）、腹膜转移（100% 对 93.8%）和骨转移（100% 对 70.5%，P < 0.001）的检出率更高。在非胆管炎肝内病变中，[18F]FAPI-04 PET显示出比[18F]FDG PET更高的SUVmax、TBR和更大的肿瘤负荷值（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）：41.3 vs. 12.4，P < 0.001；TLF vs. TLG：223.5 vs. 57.0，P < 0.001）、淋巴结转移（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）和骨转移（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）。然而，在6例阻塞性胆管炎患者中，[18F]FDG的放射性示踪剂摄取量（SUVmax：14.7 vs. 8.4，P < 0.001；TBR：7.4 vs. 2.8，P < 0.001）高于[18F]FAPI-04 PET/CT。与[18F]FDG相比，[18F]FAPI-04 PET/CT 使 23 例患者中的 6 例（26.1%）改变了治疗计划。与[18F]FDG PET/CT 相比，[18F]FAPI-04 PET/CT 对肝内病灶、淋巴结转移和远处转移（尤其是骨转移）的检出率和放射性示踪剂摄取率更高。因此，[18F]FAPI-04 PET/CT 可能是一种很有前途的 ICC 诊断和分期技术。临床试验，NCT05485792。2022年8月1日注册，回顾性注册，https//clinicaltrials.gov/study/NCT05485792?cond=NCT05485792&rank=1。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567