{"title":"18F-FAPI-42 PET/CT 提高结直肠癌腹膜转移的诊断效果并指导治疗决策：一项原创性回顾研究。","authors":"Xuneng Zhang, Rongqin Zhang, Qingyang Zheng, Zichuan He, Bing Lan, Yun Zhong, Zhichao Huang, Wei Fan, Hui Wang, Keli Yang, Zhanwen Zhang, Huaiming Wang","doi":"10.1093/gastro/goae104","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (<sup>18</sup>F-FAPI-42) and fluorine-18 fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.</p><p><strong>Methods: </strong>Forty-eight patients with PM who underwent both <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).</p><p><strong>Results: </strong>The sensitivity and accuracy of <sup>18</sup>F-FAPI-42 PET/CT for detecting PM were higher than those of <sup>18</sup>F-FDG PET/CT (82.1% vs 61.1%, <i>P </i><<i> </i>0.01; 84.6% vs 74.5%, <i>P </i><<i> </i>0.01). The median SUV max and TBR of PM was greater in <sup>18</sup>F-FAPI-42 than in <sup>18</sup>F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), <i>P </i>=<i> </i>0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), <i>P </i><<i> </i>0.01, respectively]. The median PCI of PM based on <sup>18</sup>F-FAPI-42 PET/CT was greater than that based on <sup>18</sup>F-FDG PET/CT (15 vs 9, <i>P </i><<i> </i>0.01). The ICC for <sup>18</sup>F-FAPI-42 PCI was greater than that for <sup>18</sup>F-FDG PCI (0.915 vs 0.724, <i>P </i><<i> </i>0.01). The cut-off values of the PCI of the PM for <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.</p><p><strong>Conclusions: </strong><sup>18</sup>F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of <sup>18</sup>F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the <sup>18</sup>F-FAPI-42 PET/CT PCI score is pivotal.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae104"},"PeriodicalIF":3.8000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646066/pdf/","citationCount":"0","resultStr":"{\"title\":\"<sup>18</sup>F-FAPI-42 PET/CT enhances the diagnostic efficacy for peritoneal metastasis of colorectal cancer and guides treatment decisions: an original retrospective study.\",\"authors\":\"Xuneng Zhang, Rongqin Zhang, Qingyang Zheng, Zichuan He, Bing Lan, Yun Zhong, Zhichao Huang, Wei Fan, Hui Wang, Keli Yang, Zhanwen Zhang, Huaiming Wang\",\"doi\":\"10.1093/gastro/goae104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (<sup>18</sup>F-FAPI-42) and fluorine-18 fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.</p><p><strong>Methods: </strong>Forty-eight patients with PM who underwent both <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).</p><p><strong>Results: </strong>The sensitivity and accuracy of <sup>18</sup>F-FAPI-42 PET/CT for detecting PM were higher than those of <sup>18</sup>F-FDG PET/CT (82.1% vs 61.1%, <i>P </i><<i> </i>0.01; 84.6% vs 74.5%, <i>P </i><<i> </i>0.01). The median SUV max and TBR of PM was greater in <sup>18</sup>F-FAPI-42 than in <sup>18</sup>F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), <i>P </i>=<i> </i>0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), <i>P </i><<i> </i>0.01, respectively]. The median PCI of PM based on <sup>18</sup>F-FAPI-42 PET/CT was greater than that based on <sup>18</sup>F-FDG PET/CT (15 vs 9, <i>P </i><<i> </i>0.01). The ICC for <sup>18</sup>F-FAPI-42 PCI was greater than that for <sup>18</sup>F-FDG PCI (0.915 vs 0.724, <i>P </i><<i> </i>0.01). The cut-off values of the PCI of the PM for <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.</p><p><strong>Conclusions: </strong><sup>18</sup>F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of <sup>18</sup>F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the <sup>18</sup>F-FAPI-42 PET/CT PCI score is pivotal.</p>\",\"PeriodicalId\":54275,\"journal\":{\"name\":\"Gastroenterology Report\",\"volume\":\"12 \",\"pages\":\"goae104\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646066/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Report\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/gastro/goae104\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Report","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/gastro/goae104","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
18F-FAPI-42 PET/CT enhances the diagnostic efficacy for peritoneal metastasis of colorectal cancer and guides treatment decisions: an original retrospective study.
Background: Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (18F-FAPI-42) and fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.
Methods: Forty-eight patients with PM who underwent both 18F-FAPI-42 and 18F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).
Results: The sensitivity and accuracy of 18F-FAPI-42 PET/CT for detecting PM were higher than those of 18F-FDG PET/CT (82.1% vs 61.1%, P <0.01; 84.6% vs 74.5%, P <0.01). The median SUV max and TBR of PM was greater in 18F-FAPI-42 than in 18F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), P =0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), P <0.01, respectively]. The median PCI of PM based on 18F-FAPI-42 PET/CT was greater than that based on 18F-FDG PET/CT (15 vs 9, P <0.01). The ICC for 18F-FAPI-42 PCI was greater than that for 18F-FDG PCI (0.915 vs 0.724, P <0.01). The cut-off values of the PCI of the PM for 18F-FAPI-42 and 18F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.
Conclusions: 18F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of 18F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the 18F-FAPI-42 PET/CT PCI score is pivotal.
期刊介绍：
Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.
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