淋巴瘤诊断中的成纤维细胞活化蛋白和糖酵解:68Ga-FAPI PET/CT 与 18F-FDG PET/CT 的比较。

IF 9.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Journal of Nuclear Medicine Pub Date : 2023-09-01 Epub Date: 2023-06-29 DOI:10.2967/jnumed.123.265530
Xuetao Chen, Shuailiang Wang, Yumei Lai, Guochang Wang, Maomao Wei, Xiao Jin, Jin Ding, Yan Zhang, Yunfei Shi, Feng Wang, Hua Zhu, Zhi Yang, Xuejuan Wang
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引用次数: 0

摘要

我们的目的是比较 68Ga 标记的成纤维细胞活化蛋白(FAP)抑制剂(FAPI)和 18F 标记的 FDG PET/CT 在诊断淋巴瘤方面的诊断性能,并描述 FAP 和糖酵解标记物对受累病灶示踪剂摄取的影响。研究方法2020年5月至2021年12月期间招募的不同亚型淋巴瘤患者接受了68Ga-FAPI和18F-FDG PET/CT检查。采用免疫组化方法评估FAP、己糖激酶2和葡萄糖转运体1(GLUT1)的表达,并采用配对样本t检验和Wilcoxon符号秩检验比较参数。免疫化学结果与示踪剂摄取量之间的相关性由 Spearman 秩相关系数确定。结果共纳入 186 名参与者(中位年龄 52 岁[四分位间范围 41-64 岁];95 名女性)。双示踪剂成像产生了 3 种成像特征。18F-FDG PET的分期准确率(98.4%)高于68Ga-FAPI PET(86.0%)。在5980个淋巴瘤病灶中,18F-FDG PET/CT比68Ga-FAPI PET/CT检测出更多的结节病灶(4624个对2196个)和结节外病灶(1304个对845个)。此外,还观察到52个68Ga-FAPI阳性/18F-FDG阴性病灶和2939个68Ga-FAPI阴性/18F-FDG阳性病灶。在许多淋巴瘤亚型中,半定量评估显示 68Ga-FAPI 和 18F-FDG PET/CT 的 SUVmax 或靶肝比无显著差异(P > 0.05)。有趣的是,GLUT1 和己糖激酶 2 在淋巴瘤细胞和肿瘤微环境中均过度表达,而 FAP 仅在基质细胞中表达。FAP和GLUT1的表达分别与68Ga-FAPI SUVmax(r = 0.622,P = 0.001)和18F-FDG SUVmax(r = 0.835,P < 0.001)呈正相关。结论:68Ga-FAPI PET/CT 在诊断 FAP 低表达淋巴瘤方面不如 18F-FDG PET/CT。不过,前者可作为后者的补充,有助于揭示淋巴瘤的分子特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fibroblast Activation Protein and Glycolysis in Lymphoma Diagnosis: Comparison of 68Ga-FAPI PET/CT and 18F-FDG PET/CT.

Our objective was to compare the diagnostic performance of 68Ga-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and 18F-labeled FDG PET/CT in diagnosing lymphomas and to characterize the influence of FAP and glycolytic markers on tracer uptake by involved lesions. Methods: Participants with different lymphoma subtypes who were prospectively recruited from May 2020 to December 2021 underwent 68Ga-FAPI and 18F-FDG PET/CT. Immunohistochemistry was performed to evaluate FAP, hexokinase 2, and glucose transporter 1 (GLUT1) expression, and the paired-samples t test and Wilcoxon signed-rank test were used to compare parameters. The correlation between the immunochemistry results and tracer uptake was determined by the Spearman rank correlation coefficient. Results: In total, 186 participants (median age, 52 y [interquartile range, 41-64 y]; 95 women) were included. Dual-tracer imaging produced 3 types of imaging profiles. 18F-FDG PET possessed a higher staging accuracy (98.4%) than 68Ga-FAPI PET (86.0%). In 5,980 lymphoma lesions, 18F-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than 68Ga-FAPI PET/CT. Additionally, 52 68Ga-FAPI-positive/18F-FDG-negative lesions and 2,939 68Ga-FAPI-negative/18F-FDG-positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUVmax or target-to-liver ratios between 68Ga-FAPI and 18F-FDG PET/CT (P > 0.05). Interestingly, GLUT1 and hexokinase 2 were overexpressed both in lymphoma cells and in the tumor microenvironment, whereas FAP was expressed only in stromal cells. FAP and GLUT1 expression correlated positively with 68Ga-FAPI SUVmax (r = 0.622, P = 0.001) and 18F-FDG SUVmax (r = 0.835, P < 0.001), respectively. Conclusion: 68Ga-FAPI PET/CT was inferior to 18F-FDG PET/CT in diagnosing lymphomas with low FAP expression. However, the former may supplement the latter and help reveal the molecular profile of lymphomas.

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来源期刊
Journal of Nuclear Medicine
Journal of Nuclear Medicine 医学-核医学
CiteScore
13.00
自引率
8.60%
发文量
340
审稿时长
1 months
期刊介绍: The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.
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