Imaging pancreatic cancer with [18F]F-AlF-NOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT): distribution patterns and therapeutic implications

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-05-14 DOI:10.1016/j.crad.2025.106954

C. Wang , Z. Zhu , L. Xu , W. Li , Y. Liu , H. Wang , Z. Ma , R. Zhang , X. Zhang , J. Yue

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引用次数: 0

Abstract

AIM

This study aimed to evaluate the diagnostic performance of [¹⁸F]F-AlF-NOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) in pancreatic cancer by comparing its uptake patterns with other tumour types and analysing intrapancreatic heterogeneity. The study also explored possible causes of physiological pancreatic uptake to aid in distinguishing non-malignant uptake from true pathological lesions and improve diagnostic accuracy.

MATERIALS AND METHODS

In this prospective study, 103 treatment-naïve cancer patients (36 pancreatic, 67 nonpancreatic) underwent [¹⁸F] AlF-NOTA-FAPI-04 PET/CT. Metabolic tumour volume (MTV), standardised uptake values (SUV), and total lesion Fibroblast Activation Protein (FAP) expression (TLF) were analysed. Hierarchical regression and independent t-tests were applied to assess correlations between imaging features and clinicopathological characteristics.

RESULTS

Pancreatic cancer exhibited significantly higher SUVmax (16.3 ± 4.4 vs 5.0 ± 4.3, P<0.001), SUVmean (6.3 ± 2.3 vs 1.7 ± 1.2, P<0.001), and TLF (321.5 ± 251.3 vs 89.4 ± 62.1, P<0.001) compared to non-pancreatic tumors. Tumours in the pancreatic head/neck region demonstrated greater [68 G]G-FAPI-04 uptake than body/tail lesions (SUVmean: 7.7 ± 3.1 vs 6.3 ± 2.9, P=0.016). TLF correlated positively with tumour size and stage (F = 2.576, P=0.027). Mild to moderate pancreatic uptake was also observed in a subset of patients with hepatocellular carcinoma, partially correlating with elevated alkaline phosphatase (ALP) levels.

CONCLUSION

[¹⁸F]F-AlF-NOTA-FAPI-04 PET/CT shows high specificity for pancreatic ductal adenocarcinoma, particularly in head/neck tumours. Physiological or nonspecific pancreatic uptake in nonpancreatic malignancies warrants careful interpretation to avoid misdiagnosis.

查看原文本刊更多论文

[18F]F-AlF-NOTA-FAPI-04正电子发射断层扫描/计算机断层扫描（PET/CT）成像胰腺癌：分布模式和治疗意义

目的本研究旨在通过比较[18F]F-AlF-NOTA-FAPI-04正电子发射断层扫描/计算机断层扫描（PET/CT）与其他肿瘤类型的摄取模式并分析胰腺内异质性，评价其对胰腺癌的诊断价值。该研究还探讨了生理性胰腺摄取的可能原因，以帮助区分非恶性摄取和真正的病理病变，提高诊断准确性。材料和方法在这项前瞻性研究中，103例treatment-naïve癌症患者（36例胰腺，67例非胰腺）接受了[18F] AlF-NOTA-FAPI-04 PET/CT检查。分析代谢肿瘤体积（MTV）、标准化摄取值（SUV）和病变总成纤维细胞激活蛋白（FAP）表达（TLF）。应用层次回归和独立t检验评估影像学特征与临床病理特征之间的相关性。结果胰腺癌的SUVmax（16.3±4.4 vs 5.0±4.3,P<0.001）、SUVmean（6.3±2.3 vs 1.7±1.2,P<0.001）和TLF（321.5±251.3 vs 89.4±62.1,P<0.001）明显高于非胰腺肿瘤。胰脏头颈部肿瘤对[68 G]G- fapi -04的摄取高于身体/尾部病变（suv平均值：7.7±3.1 vs 6.3±2.9，P=0.016）。TLF与肿瘤大小、分期呈正相关（F = 2.576， P=0.027）。在一部分肝细胞癌患者中也观察到轻度至中度胰腺摄取，这与碱性磷酸酶（ALP）水平升高部分相关。结论[18F]F-AlF-NOTA-FAPI-04 PET/CT对胰腺导管腺癌，尤其是头颈部肿瘤具有较高的特异性。非胰腺恶性肿瘤的生理性或非特异性胰腺摄取需要仔细解释以避免误诊。

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

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.