{"title":"比较[18F]FAPI-42和[18F]FDG PET/CT在系统性血管炎评估中的应用","authors":"Kaixiang Zhong, Haiming Chen, Peng Hou, Linling Cheng, Wenliang Guo, Youcai Li, Jie Lv, Miao Ke, Xiaofeng Wu, Yongxia Lei, Chunli Liu, Cheng Hong, Xinlu Wang","doi":"10.1007/s00259-024-06986-2","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The role of fibroblast activation protein (FAP)-targeted imaging in systemic vasculitis is currently unclear. We aimed to evaluate the clinical value of fluorine-18-labeled FAP inhibitor 42 ([<sup>18</sup>F]FAPI-42) in patients with systemic vasculitis and to compare with [<sup>18</sup>F]fluorodeoxyglucose (FDG) imaging.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients with systemic vasculitis who underwent dual-tracer PET/CT([<sup>18</sup>F]FDG and [<sup>18</sup>F]FAPI) imaging from September 2020 to March 2022 were retrospectively analyzed. Positive lesions are defined as vascular/extravascular lesions with increased tracer uptake above surrounding background, which cannot be attributed to the physiologic biodistribution of the radiotracer. The vascular/extravascular lesion detection rate and semiquantitative values (SUVmax, TBR<sub>blood</sub> and TBR<sub>liver</sub>) of [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG were compared, and the correlation between the extent and range of tracer uptake and levels of inflammatory markers was investigated.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Thirty patients (13 males and 17 females; mean age, 52.5 ± 17.2 years) with systemic vasculitis were included (17 large vessel vasculitis, 10 anti-neutrophil cytoplasmic antibody-associated vasculitis, 2 Behcet’s disease and 1 polyarteritis nodosa). [<sup>18</sup>F]FDG PET/CT had positive findings in 93.3% (28/30) of patients, while [<sup>18</sup>F]FAPI PET/CT had positive findings in all patients (100%, <i>P</i> = 0.500). Compared with [<sup>18</sup>F]FDG PET/CT, [<sup>18</sup>F]FAPI PET/CT detected more lesions (161/168 vs. 145/168, <i>P</i> = 0.005), and more extensive vascular involvement in 60% (18/30) of patients. Although SUVmax did not differ significantly between [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG (median, 5.94 vs. 5.46, <i>P</i> = 0.517), [<sup>18</sup>F]FAPI had higher TBR<sub>liver</sub> (median, 9.59 vs. 3.15, <i>P</i> < 0.001) and TBR<sub>blood</sub> (median, 5.45 vs. 4.20, <i>P</i> = 0.006). The total number of positive lesions in FAPI PET/CT show a moderate correlation with erythrocyte sedimentation rate (<i>r</i><sub><i>s</i></sub> =0.478, <i>P</i> = 0.008) and C-reactive protein (<i>r</i><sub><i>s</i></sub> =0.486, <i>P</i> = 0.006). After treatment, follow-up FAPI PET/CT of 6 patients showed decreased SUVmax, TBR and number of detected lesions, paralleling the clinical remission.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>[<sup>18</sup>F]FAPI PET/CT imaging is a promising imaging modality for the diagnosis and therapeutic monitoring of systemic vasculitis.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"67 1","pages":""},"PeriodicalIF":8.6000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of [18F]FAPI-42 and [18F]FDG PET/CT in the evaluation of systemic vasculitis\",\"authors\":\"Kaixiang Zhong, Haiming Chen, Peng Hou, Linling Cheng, Wenliang Guo, Youcai Li, Jie Lv, Miao Ke, Xiaofeng Wu, Yongxia Lei, Chunli Liu, Cheng Hong, Xinlu Wang\",\"doi\":\"10.1007/s00259-024-06986-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>The role of fibroblast activation protein (FAP)-targeted imaging in systemic vasculitis is currently unclear. We aimed to evaluate the clinical value of fluorine-18-labeled FAP inhibitor 42 ([<sup>18</sup>F]FAPI-42) in patients with systemic vasculitis and to compare with [<sup>18</sup>F]fluorodeoxyglucose (FDG) imaging.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>Patients with systemic vasculitis who underwent dual-tracer PET/CT([<sup>18</sup>F]FDG and [<sup>18</sup>F]FAPI) imaging from September 2020 to March 2022 were retrospectively analyzed. Positive lesions are defined as vascular/extravascular lesions with increased tracer uptake above surrounding background, which cannot be attributed to the physiologic biodistribution of the radiotracer. The vascular/extravascular lesion detection rate and semiquantitative values (SUVmax, TBR<sub>blood</sub> and TBR<sub>liver</sub>) of [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG were compared, and the correlation between the extent and range of tracer uptake and levels of inflammatory markers was investigated.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Thirty patients (13 males and 17 females; mean age, 52.5 ± 17.2 years) with systemic vasculitis were included (17 large vessel vasculitis, 10 anti-neutrophil cytoplasmic antibody-associated vasculitis, 2 Behcet’s disease and 1 polyarteritis nodosa). [<sup>18</sup>F]FDG PET/CT had positive findings in 93.3% (28/30) of patients, while [<sup>18</sup>F]FAPI PET/CT had positive findings in all patients (100%, <i>P</i> = 0.500). Compared with [<sup>18</sup>F]FDG PET/CT, [<sup>18</sup>F]FAPI PET/CT detected more lesions (161/168 vs. 145/168, <i>P</i> = 0.005), and more extensive vascular involvement in 60% (18/30) of patients. Although SUVmax did not differ significantly between [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG (median, 5.94 vs. 5.46, <i>P</i> = 0.517), [<sup>18</sup>F]FAPI had higher TBR<sub>liver</sub> (median, 9.59 vs. 3.15, <i>P</i> < 0.001) and TBR<sub>blood</sub> (median, 5.45 vs. 4.20, <i>P</i> = 0.006). The total number of positive lesions in FAPI PET/CT show a moderate correlation with erythrocyte sedimentation rate (<i>r</i><sub><i>s</i></sub> =0.478, <i>P</i> = 0.008) and C-reactive protein (<i>r</i><sub><i>s</i></sub> =0.486, <i>P</i> = 0.006). After treatment, follow-up FAPI PET/CT of 6 patients showed decreased SUVmax, TBR and number of detected lesions, paralleling the clinical remission.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>[<sup>18</sup>F]FAPI PET/CT imaging is a promising imaging modality for the diagnosis and therapeutic monitoring of systemic vasculitis.</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\"67 1\",\"pages\":\"\"},\"PeriodicalIF\":8.6000,\"publicationDate\":\"2024-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-024-06986-2\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-024-06986-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Comparison of [18F]FAPI-42 and [18F]FDG PET/CT in the evaluation of systemic vasculitis
Purpose
The role of fibroblast activation protein (FAP)-targeted imaging in systemic vasculitis is currently unclear. We aimed to evaluate the clinical value of fluorine-18-labeled FAP inhibitor 42 ([18F]FAPI-42) in patients with systemic vasculitis and to compare with [18F]fluorodeoxyglucose (FDG) imaging.
Methods
Patients with systemic vasculitis who underwent dual-tracer PET/CT([18F]FDG and [18F]FAPI) imaging from September 2020 to March 2022 were retrospectively analyzed. Positive lesions are defined as vascular/extravascular lesions with increased tracer uptake above surrounding background, which cannot be attributed to the physiologic biodistribution of the radiotracer. The vascular/extravascular lesion detection rate and semiquantitative values (SUVmax, TBRblood and TBRliver) of [18F]FAPI and [18F]FDG were compared, and the correlation between the extent and range of tracer uptake and levels of inflammatory markers was investigated.
Results
Thirty patients (13 males and 17 females; mean age, 52.5 ± 17.2 years) with systemic vasculitis were included (17 large vessel vasculitis, 10 anti-neutrophil cytoplasmic antibody-associated vasculitis, 2 Behcet’s disease and 1 polyarteritis nodosa). [18F]FDG PET/CT had positive findings in 93.3% (28/30) of patients, while [18F]FAPI PET/CT had positive findings in all patients (100%, P = 0.500). Compared with [18F]FDG PET/CT, [18F]FAPI PET/CT detected more lesions (161/168 vs. 145/168, P = 0.005), and more extensive vascular involvement in 60% (18/30) of patients. Although SUVmax did not differ significantly between [18F]FAPI and [18F]FDG (median, 5.94 vs. 5.46, P = 0.517), [18F]FAPI had higher TBRliver (median, 9.59 vs. 3.15, P < 0.001) and TBRblood (median, 5.45 vs. 4.20, P = 0.006). The total number of positive lesions in FAPI PET/CT show a moderate correlation with erythrocyte sedimentation rate (rs =0.478, P = 0.008) and C-reactive protein (rs =0.486, P = 0.006). After treatment, follow-up FAPI PET/CT of 6 patients showed decreased SUVmax, TBR and number of detected lesions, paralleling the clinical remission.
Conclusion
[18F]FAPI PET/CT imaging is a promising imaging modality for the diagnosis and therapeutic monitoring of systemic vasculitis.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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