68Ga-DOTA-FAPI-04 PET/CT与18F-FDG PET/CT评价不同骨转移癌的优越性

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2025-03-12 DOI:10.1016/j.bone.2025.117426

Rui Guo , Fei Wang , Hua Su , Xiangxi Meng , Qing Xie , Wei Zhao , Zhi Yang , Nan Li

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引用次数: 0

摘要

背景：68Ga-DOTA-FAPI-04是一种新型正电子显像剂，在骨转移中的应用受到限制。本回顾性研究的目的是比较68Ga-DOTA-FAPI-04 PET/CT与18F-FDG PET/CT对不同类型肿瘤患者骨转移的诊断能力。方法：采用68Ga-DOTA-FAPI-04 PET/CT和18F-FDG PET/CT对293例经病理证实的原发性恶性肿瘤患者进行一周内的检查。以病理检查或随访CT或MRI扫描为金标准，比较两种方法鉴别骨转移的诊断效果（p ）结果：共确诊骨转移48例，无骨转移245例。骨转移376例，良性骨病变243例。68Ga-DOTA-FAPI-04 PET/CT和18F-FDG PET/CT分别检测到376例和228例转移灶。敏感性、特异性、正面和负面预测值(PPV和NPV)和准确性68 ga-dota-fapi-04 PET / CT和18 f-fdg PET / CT是100.0 vs 60.6  % % 93.8 vs 99.2  % % 96.2 vs 99.2  % %,% 62.0 vs 100.0   % %和97.6 vs 75.8 %,分别。与18F-FDG相比，良性骨病变和转移灶中68Ga-DOTA-FAPI-04的摄取均显著增加（p = 0.001）。68Ga-DOTA-FAPI-04对成骨细胞转移的摄食量也明显高于18F-FDG （p ），68Ga-DOTA-FAPI-04摄食量高于18F-FDG PET/CT （p ），68Ga-DOTA-FAPI-04 PET/CT和18F-FDG PET/CT，可以预测转移的发生（AUC = 0.817,95 % CI: 0.791-0.923 vs AUC =0.751,95%CI:0.626-0.875）。结论：与18F-FDG相比，68Ga-DOTA-FAPI-04作为一种新型显像剂，能够检出更多的骨转移灶，示踪剂摄取水平也更高。特别是对于肺癌和胃癌，68Ga-DOTA-FAPI-04 PET/CT可能是一种更可靠的骨转移检测手段。

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Superiority of 68Ga-DOTA-FAPI-04 PET/CT to 18F-FDG PET/CT in the evaluation of different cancers with bone metastases

Background

⁶⁸Ga-DOTA-FAPI-04 is a new positron imaging agent, and its application in bone metastasis has been limited. The purpose of this retrospective study was to compare the diagnostic ability of ⁶⁸Ga-DOTA-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT to detect bone metastases in patients with different types of cancer.

Methods

A total of 293 patients with pathologically confirmed primary malignancies were examined with ⁶⁸Ga-DOTA-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT within one week. Using pathological examination or follow-up CT or MRI scan as the gold standard, the diagnostic efficacy of the two methods in differentiating bone metastases was compared (p < 0.05, with statistical significance). The maximum standard uptake value (SUVmax) of the two methods for different types of bone metastasis was further compared. The SUVmax was used to compare the differences between the two methods in detecting bone metastases in different tumor types and different sites.

Results

A total of 48 patients were diagnosed with bone metastasis, and 245 patients without bone metastasis. There were 376 bone metastases and 243 benign bone lesions. ⁶⁸Ga-DOTA-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT detected 376 and 228 metastases, respectively. Sensitivity, specificity, positive and negative predictive value (PPV and NPV) and accuracy of ⁶⁸Ga-DOTA-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT were 100.0 % vs 60.6 %, 93.8 % vs 99.2 %, 96.2 % vs 99.2 %, 100.0 % vs 62.0 % and 97.6 % vs 75.8 %, respectively. Compared with ¹⁸F-FDG, ⁶⁸Ga-DOTA-FAPI-04 uptake was significantly increased in both benign bone lesions and metastases (p = 0.001). The uptake of ⁶⁸Ga-DOTA-FAPI-04 for osteoblastic metastasis was also significantly higher than that of ¹⁸F-FDG (p < 0.001). In bone metastasis of lung cancer and gastric cancer, ⁶⁸Ga-DOTA-FAPI-04 uptake was higher than that of ¹⁸F-FDG PET/CT (p < 0.05). Using SUVmax = 4.1 and SUVmax = 6.2 as the cutoff value by ⁶⁸Ga-DOTA-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT, it was possible to predict the occurrence of metastases (AUC = 0.817,95 % CI: 0.791–0.923 vs AUC =0.751,95%CI:0.626–0.875).

Conclusions

⁶⁸Ga-DOTA-FAPI-04 as a novel imaging agent, can detect more bone metastases and has a higher tracer uptake level than ¹⁸F-FDG. Especially for lung and gastric cancer, ⁶⁸Ga-DOTA-FAPI-04 PET/CT may be a more reliable means to detect bone metastases.

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.