前瞻性比较[18F]FDG 和[18F]AIF-FAPI-74 PET/CT 在评估潜在可切除胰腺导管腺癌中的应用

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

Molecular Imaging and Biology Pub Date : 2024-10-04 DOI:10.1007/s11307-024-01950-w

Won-Gun Yun, Joonhyung Gil, Hongyoon Choi, Youngmin Han, Hye-Sol Jung, Young Jae Cho, Minseok Suh, Wooil Kwon, Yun-Sang Lee, Gi Jeong Cheon, Jin-Young Jang

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引用次数: 0

摘要

目的：对可能切除的胰腺导管腺癌（PDAC）进行准确的临床分期对于制定最佳治疗策略至关重要。虽然氟-18-氟脱氧葡萄糖（[18F]FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在临床分期中的疗效尚不明确，但检测成纤维细胞活化蛋白（FAP）表达的 PET/CT 最近在高灵敏度检测包括 PDAC 在内的各种肿瘤方面受到了广泛关注。我们探讨了[18F]FDG和[18F]AIF-FAPI-74 PET/CT在初步评估潜在可切除PDAC中的疗效：2021年至2022年间，20名新确诊的潜在可切除PDAC患者入组。通过胰腺 CT、[18F]FDG PET/CT 和 [18F]AIF-FAPI-74 PET/CT 进行初步评估后，根据参与者的一般状况、临床分期和可切除性确定治疗策略。只有17名接受了根治性手术的患者可以获得手术标本的病理信息。对不同成像模式的放射性示踪剂定量摄取和诊断性能进行了头对头比较：结果：在评估原发性胰腺病变时，[18F]AIF-FAPI-74 PET/CT 显示的最大标准化摄取值明显高于[18F]FDG PET/CT （中位数[四分位间范围]；12.6 [10.7-13.7] vs. 6.3 [4.8-9.2]; P 18F]AIF-FAPI-74 PET/CT 在评估背景器官时显示的平均标准化摄取值明显低于[18F]FDG PET/CT（中位[四分位间范围]）0.8 [0.7-0.9] vs. 2.6 [2.3-2.7]；18F]AIF-FAPI-74 PET/CT 检测转移淋巴结的平均标准化摄取值高于[18F]FDG PET/CT（50.0% vs. 0.0%；P = 0.026）：本研究表明，[18F]AIF-FAPI-74 PET/CT 可改善潜在可切除 PDAC 的临床分期。

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Prospective Comparison of [¹⁸F]FDG and [¹⁸F]AIF-FAPI-74 PET/CT in the Evaluation of Potentially Resectable Pancreatic Ductal Adenocarcinoma.

Purpose: Accurate clinical staging of potentially resectable pancreatic ductal adenocarcinoma (PDAC) is critical for establishing optimal treatment strategies. While the efficacy of fluorine-18-fluorodeoxyglucose ([¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT) in clinical staging is unclear, PET/CT detecting fibroblast-activation protein (FAP) expression has recently received considerable attention for detecting various tumors, including PDAC, with high sensitivity. We explored the efficacy of [¹⁸F]FDG and [¹⁸F]AIF-FAPI-74 PET/CT in the initial evaluation of potentially resectable PDAC.

Procedures: Between 2021 and 2022, twenty participants with newly diagnosed potentially resectable PDAC were enrolled. After the initial evaluation with pancreatic CT, [¹⁸F]FDG PET/CT, and [¹⁸F]AIF-FAPI-74 PET/CT, treatment strategies were determined considering the participant's general status, clinical staging, and resectability. Pathological information from the surgical specimens was only available in 17 participants who underwent curative-intent surgery. Head-to-head comparisons of quantitative radiotracer uptake and diagnostic performance were performed among imaging modalities.

Results: [¹⁸F]AIF-FAPI-74 PET/CT showed a significantly higher maximum standardized uptake value than [¹⁸F]FDG PET/CT did in evaluating primary pancreatic lesions (median [interquartile range]; 12.6 [10.7-13.7] vs. 6.3 [4.8-9.2]; P < 0.001). In contrast, [¹⁸F]AIF-FAPI-74 PET/CT showed a significantly lower mean standardized uptake value than [¹⁸F]FDG PET/CT did in evaluating background organ (median [interquartile range]) 0.8 [0.7-0.9] vs. 2.6 [2.3-2.7]; P < 0.001). In addition, the sensitivity of [¹⁸F]AIF-FAPI-74 PET/CT in detecting metastatic lymph nodes was higher than that of [¹⁸F]FDG PET/CT (50.0% vs. 0.0%; P = 0.026).

Conclusion: This study demonstrated that [¹⁸F]AIF-FAPI-74 PET/CT could improve the clinical staging of potentially resectable PDAC.

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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.