Head-to-head comparison of ¹⁸F-FDG and ⁶⁸Ga-FAPI PET/CT in common gynecological malignancies.

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging Pub Date : 2025-02-28 DOI:10.1186/s40644-025-00843-7

Tengfei Li, Jintao Zhang, Yuanzhuo Yan, Yue Zhang, Wenjie Pei, Qingchu Hua, Yue Chen

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引用次数: 0

Abstract

Background: ⁶⁸Ga-FAPI (fibroblast activation protein inhibitor) is a novel and highly promising radiotracer for PET/CT imaging. It has shown significant tumor uptake and high sensitivity in lesion detection across a range of cancer types. We aimed to compare the diagnostic value of ⁶⁸Ga-FAPI and ¹⁸F-FDG PET/CT in common gynecological malignancies.

Methods: This retrospective study included 35 patients diagnosed with common gynecological tumors, including breast cancer, ovarian cancer, and cervical cancer. Among the 35 patients, 27 underwent PET/CT for the initial assessment of tumors, while 8 were assessed for recurrence detection. The median and range of tumor size and maximum standardized uptake values (SUV_max) were calculated.

Results: Thirty-five patients (median age, 57 years [interquartile range], 51-65 years) were evaluated. In treatment-naive patients (n = 27), ⁶⁸Ga-FAPI PET/CT led to upstaging of the clinical TNM stage in five (19%) patients compared with ¹⁸F-FDG PET/CT. No significant difference in tracer uptake was observed between ¹⁸F-FDG and ⁶⁸Ga-FAPI for primary lesions: breast cancer (7.2 vs. 4.9, P = 0.086), ovarian cancer (16.3 vs. 15.7, P = 0.345), and cervical cancer (18.3 vs. 17.1, P = 0.703). For involved lymph nodes, ⁶⁸Ga-FAPI PET/CT demonstrated a higher SUV_max for breast cancer (9.9 vs. 6.1, P = 0.007) and cervical cancer (6.3 vs. 4.8, P = 0.048), while no significant difference was noted for ovarian cancer (7.0 vs. 5.9, P = 0.179). Furthermore, ⁶⁸Ga-FAPI PET/CT demonstrated higher specificity and accuracy compared to ¹⁸F-FDG PET/CT for detecting metastatic lymph nodes (100% vs. 66%, P < 0.001; 94% vs. 80%, P < 0.001). In contrast, sensitivity did not differ significantly (97% vs. 86%, P = 0.125). For most distant metastases, ⁶⁸Ga-FAPI exhibited a higher SUV_max than ¹⁸F-FDG in bone metastases (12.9 vs. 4.9, P = 0.036).

Conclusions: ⁶⁸Ga-FAPI PET/CT demonstrated higher tracer uptake and was superior to ¹⁸F-FDG PET/CT in detecting primary and metastatic lesions in patients with common gynecological malignancies.

Trial registration: ChiCTR, ChiCTR2100044131. Registered 10 October 2022, https://www.chictr.org.cn , ChiCTR2100044131.

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18F-FDG与68Ga-FAPI在常见妇科恶性肿瘤的PET/CT对比研究

背景：68Ga-FAPI（成纤维细胞活化蛋白抑制剂）是一种新型的、非常有前途的PET/CT成像示踪剂。它在一系列癌症类型的病变检测中显示出显著的肿瘤摄取和高灵敏度。我们旨在比较68Ga-FAPI和18F-FDG PET/CT在常见妇科恶性肿瘤中的诊断价值。方法：回顾性研究35例诊断为常见妇科肿瘤的患者，包括乳腺癌、卵巢癌和宫颈癌。35例患者中，27例行PET/CT初步评估肿瘤，8例行复发检测。计算肿瘤大小的中位数和范围以及最大标准化摄取值（SUVmax）。结果：35例患者（中位年龄57岁[四分位数间距]，51-65岁）接受评估。在未接受治疗的患者（n = 27）中，与18F-FDG PET/CT相比，68Ga-FAPI PET/CT导致5例（19%）患者的临床TNM期提前。在乳腺癌（7.2 vs. 4.9, P = 0.086）、卵巢癌（16.3 vs. 15.7, P = 0.345）和宫颈癌（18.3 vs. 17.1, P = 0.703）的原发病变中，18F-FDG和68Ga-FAPI的示踪剂摄取无显著差异。对于受病灶淋巴结，68Ga-FAPI PET/CT显示乳腺癌（9.9 vs. 6.1, P = 0.007）和宫颈癌（6.3 vs. 4.8, P = 0.048）的SUVmax更高，而卵巢癌（7.0 vs. 5.9, P = 0.179）的SUVmax差异无统计学意义。此外，与18F-FDG PET/CT相比，68Ga-FAPI PET/CT在检测转移淋巴结方面表现出更高的特异性和准确性（100%比66%），p68ga - fapi在骨转移方面表现出比18F-FDG更高的SUVmax（12.9比4.9,P = 0.036）。结论：68Ga-FAPI PET/CT对常见妇科恶性肿瘤患者的示踪剂摄取更高，在发现原发性和转移性病变方面优于18F-FDG PET/CT。试验注册：ChiCTR， ChiCTR2100044131。2022年10月10日注册，https://www.chictr.org.cn, ChiCTR2100044131。

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来源期刊

Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.