Head-to-head comparison of ⁶⁸ Ga-FAPI-46 PET/CT, ¹⁸F-FDG PET/CT, and contrast-enhanced CT for the detection of various tumors.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2024-10-23 DOI:10.1007/s12149-024-01993-7

Masao Watanabe, Wolfgang P Fendler, Hong Grafe, Nader Hirmas, Rainer Hamacher, Helena Lanzafame, Kim M Pabst, Hubertus Hautzel, Clemens Aigner, Stefan Kasper, Bastian von Tresckow, Martin Stuschke, Sherko Kümmel, Celine Lugnier, Boris Hadaschik, Viktor Grünwald, Fadi Zarrad, David Kersting, Jens T Siveke, Ken Herrmann, Manuel Weber

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引用次数: 0

Abstract

Objective: FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of ⁶⁸ Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), ¹⁸F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.

Methods: 232 patients underwent ⁶⁸ Ga-FAPI-46 PET/CT,¹⁸F-FDG PET/CT, and CE-CT each within 4 weeks. Detection rates were assessed by a blinded reader, with ≥ 2 weeks between scans of the same patient to avoid recall bias. A sub-analysis of diagnostic performance was performed for 490 histopathologically validated lesions. Detection rates were compared using McNemar's test.

Results: Lesion-based detection rates in ⁶⁸ Ga-FAPI-46 PET/CT plus CE-CT, ¹⁸F-FDG PET/CT plus CE-CT, and CE-CT alone were 91.2% (1540/1688), 82.5% (1393/1688) and 60.2% (1016/1688). The detection rates were significantly higher for ⁶⁸ Ga-FAPI-46 PET/CT plus CE-CT than for ¹⁸F-FDG PET/CT plus CE-CT (p < 0.02 for primary lesions and p < 0.001 for total, abdominopelvic nodal, liver and other visceral lesions) and CE-CT (p < 0.0001 for total, primary, cervicothoracic nodal, abdominopelvic nodal, liver, other visceral, and bone lesions). In the sub-analysis, sensitivity, specificity, positive and negative predictive value, and accuracy were 61.3%, 96.7%, 81.4%, 91.4% and 90.0% for ⁶⁸ Ga-FAPI-46 PET/CT plus CE-CT, 57.0%, 95.7%, 75.7%, 90.5% and 88.4% for ¹⁸F-FDG PET/CT plus CE-CT, and 51.6%, 97.2%, 81.4%, 89.6% and 88.6% for CECT, respectively.

Conclusions: ⁶⁸ Ga-FAPI-46 PET/CT plus CE-CT demonstrates a higher tumor detection rate than ¹⁸F-FDG PET/CT plus CE-CT and CE-CT in a diverse spectrum of malignancies, especially for primary, abdominopelvic nodal, liver, and other visceral lesions. Further studies on which entities draw particular benefit from ⁶⁸ Ga-FAPI-46 PET/CT are warranted to aid appropriate diagnostic workup.

Trial registration: A total of N = 232 patients were analyzed. Of these, N = 50 patients were included in a prospective interventional trial (NCT05160051), and N = 175 in a prospective observational trial (NCT04571086) for correlation and clinical follow-up of PET findings; N = 7 patients were analyzed retrospectively.

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68 Ga-FAPI-46 PET/CT、18F-FDG PET/CT 和对比增强 CT 在检测各种肿瘤方面的头对头比较。

目的：FAPI-PET/CT具有高肿瘤摄取和低背景累积的特点，可实现高灵敏度的肿瘤检测。我们比较了 68 Ga-FAPI-46 PET/CT 加对比增强 CT（CE-CT）、18F-FDG PET/CT 加 CE-CT 和独立 CE-CT 对各种恶性肿瘤患者的诊断性能。检测率由一名盲读者评估，同一患者的扫描间隔≥2周，以避免回忆偏差。对 490 个经组织病理学验证的病变进行了诊断性能子分析。采用麦克尼马检验比较了检出率：68 Ga-FAPI-46 PET/CT 加 CE-CT、18F-FDG PET/CT 加 CE-CT 和单独 CE-CT 基于病灶的检出率分别为 91.2%（1540/1688）、82.5%（1393/1688）和 60.2%（1016/1688）。68 Ga-FAPI-46 PET/CT 加 CE-CT 的检出率明显高于 18F-FDG PET/CT 加 CE-CT （P 68 Ga-FAPI-46 PET/CT 加 CE-CT、18F-FDG PET/CT 加 CE-CT 分别为 57.0%、95.7%、75.7%、90.5% 和 88.4%，CECT 分别为 51.6%、97.2%、81.4%、89.6% 和 88.6%）：68Ga-FAPI-46 PET/CT加CE-CT在多种恶性肿瘤中的肿瘤检出率高于18F-FDG PET/CT加CE-CT和CE-CT，尤其是在原发性、腹盆腔结节、肝脏和其他内脏病变中。有必要进一步研究哪些实体可从 68 Ga-FAPI-46 PET/CT 中特别获益，以帮助进行适当的诊断工作：共分析了 N = 232 名患者。其中，N = 50 例患者被纳入前瞻性介入试验（NCT05160051），N = 175 例患者被纳入前瞻性观察试验（NCT04571086），以对 PET 结果进行相关性分析和临床随访；N = 7 例患者被进行回顾性分析。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.