The Imaging Value of ¹⁸F-FAPI PET/CT in Sorafenib-Induced Cardiac Dysfunction in Patients with Hepatocellular Carcinoma: Compared with ¹⁸F-FDG PET/CT.

IF 3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2025-06-01 Epub Date: 2025-04-30 DOI:10.1007/s11307-025-02005-4

Yingqi Luo, Qingqi Yang, Xiaowen Qin, Boyang Yu, Shengnan Jiang, Ying Liu

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引用次数: 0

Abstract

Purpose: Evaluation of ¹⁸F-FAPI PET/CT imaging in sorafenib-induced cardiac dysfunction in hepatocellular carcinoma (HCC) patients, and compared with ¹⁸F-FDG PET/CT.

Procedures: This retrospective study enrolled 75 HCC patients treated with sorafenib at our institution from June 2021 to June 2023. All patients underwent ¹⁸F-FDG PET/CT six months after treatment, followed by ¹⁸F-FAPI PET/CT within the subsequent week. Patients were divided into cardiac dysfunction group and control group based on the definition of cancer therapy-related cardiac dysfunction (CTRCD). Myocardial uptake parameters on ¹⁸F-FDG and ¹⁸F-FAPI PET/CT were compared between the two groups. The primary endpoint was the occurrence of major adverse cardiac events (MACEs), and the secondary endpoint was all-cause mortality, with follow-up at 30, 90, and 180 days after the PET/CT examinations.

Results: This study ultimately enrolled 47 patients, with the cardiac dysfunction group (n = 9) and control group (n = 38) demonstrating significant differences in myocardial ¹⁸F-FAPI high uptake, left ventricular (LV) ¹⁸F-FDG SUV, LV/liver ¹⁸F-FDG SUV, myocardial ¹⁸F-FAPI SUV, myocardial/aorta ¹⁸F-FAPI SUV, and myocardial/liver ¹⁸F-FAPI SUV. One year after treatment, the incidence of MACEs was slightly higher in the group with high ¹⁸F-FAPI myocardial uptake compared to the low uptake group (19.5% vs. 14.0%, log-rank p = 0.621), and the overall survival rate was lower in the high uptake group compared to the low uptake group (57.9% vs. 65.8%, log-rank p = 0.503).

Conclusions: The myocardial uptake parameters of ¹⁸F-FDG and ¹⁸F-FAPI PET/CT are helpful in evaluating sorafenib-induced cardiac dysfunction in HCC patients. The level of ¹⁸F-FAPI myocardial uptake has potential value in predicting post-treatment cardiotoxicity and overall survival prognosis in HCC patients.

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18F-FAPI PET/CT在索拉非尼致肝癌心功能障碍中的成像价值：与18F-FDG PET/CT比较

目的：评价18F-FAPI PET/CT在索拉非尼诱导的肝细胞癌（HCC）患者心功能障碍中的表现，并与18F-FDG PET/CT进行比较。程序：本回顾性研究纳入了2021年6月至2023年6月在我院接受索拉非尼治疗的75例HCC患者。所有患者在治疗后6个月接受了18F-FDG PET/CT检查，并在随后的一周内接受了18F-FAPI PET/CT检查。根据癌症治疗相关性心功能障碍（CTRCD）的定义，将患者分为心功能障碍组和对照组。比较两组18F-FDG和18F-FAPI PET/CT心肌摄取参数。主要终点是主要心脏不良事件（mace）的发生，次要终点是全因死亡率，随访时间分别为PET/CT检查后30、90和180天。结果：本研究最终纳入47例患者，心功能障碍组（n = 9）和对照组（n = 38）在心肌18F-FAPI高摄取、左心室（LV） 18F-FDG SUV、LV/肝脏18F-FDG SUV、心肌18F-FAPI SUV、心肌/主动脉18F-FAPI SUV和心肌/肝脏18F-FAPI SUV方面存在显著差异。治疗一年后，18F-FAPI心肌摄取高组的mace发生率略高于低摄取组（19.5%比14.0%,log-rank p = 0.621），高摄取组的总生存率低于低摄取组（57.9%比65.8%,log-rank p = 0.503）。结论：18F-FDG和18F-FAPI PET/CT心肌摄取参数有助于评价索拉非尼致HCC患者心功能障碍。18F-FAPI心肌摄取水平在预测HCC患者治疗后心脏毒性和总体生存预后方面具有潜在价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.