在[18F]FDG后使用[68 Ga]Ga- fapi -04进行当日双示踪PET/CT成像，可以在[18F]FDG阴性或不明确的患者中找到答案。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2025-07-04 DOI:10.1007/s12149-025-02080-1

Hongyan Li, Chongjiao Li, Yueli Tian, Zhiwei Xiao, Diankui Xing, Yong He

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引用次数: 0

摘要

目的：镓-68标记的成纤维细胞活化蛋白抑制剂（[68 Ga]Ga- fapi）是一种肿瘤间质显像剂，与氟-18氟脱氧葡萄糖（[18F]FDG）在癌症成像中具有互补价值。本研究探讨了[68 Ga]Ga- fapi -04在[18F]FDG阴性或不明确的患者中进行[18F]FDG的同日双示踪正电子发射断层扫描/计算机断层扫描（PET/CT）方案的可行性。方法：对[18F]FDG阴性或不明确的患者，同日行双示踪PET/CT（命名为FDG-mixed FAPI PET/CT，简称mFAPI PET/CT），在注射[18F]FDG后4.0 ~ 7.75 h给予[68 Ga]Ga-FAPI-04。比较[18F]FDG和mFAPI PET/CT的病变检出率和病灶与背景摄取比（LBRs）。结果：44例患者纳入分析。mFAPI PET在原发性肿瘤检测方面优于[18F]FDG PET (86.2% [25/29] vs. 37.9% [11/29])， p18f]FDG在大多数病变，特别是淋巴结、腹膜和肝脏转移(所有p18f]FDG在不同临床情况下，包括88.9%（8/9）的可疑病变特征，46.2%（6/13）的原发部位定位，81.8%（9/11）的肿瘤分期升级，81.8%（9/11）的复发识别。结论：在[18F]FDG后采用[68 Ga]Ga- fapi -04的当日双示踪PET/CT方案，可提高对不确定病变的识别能力，定位未知的恶性原发肿瘤部位，并准确提供阴性或不明确[18F]FDG患者的分期和再分期。试验注册：NCT05034146。注册于2021年2月23日。

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Same-day dual-tracer PET/CT imaging with [⁶⁸ Ga]Ga-FAPI-04 following [¹⁸F]FDG finds answers in patients presenting with negative or equivocal [¹⁸F]FDG.

Objective: Gallium-68-labelled fibroblast activation protein inhibitor ([⁶⁸ Ga]Ga-FAPI) is a tumour-stromal imaging agent showing complementary value alongside fluorine-18 fluorodeoxyglucose ([¹⁸F]FDG) in cancer imaging. This study investigated the feasibility of a same-day dual-tracer positron emission tomography/computed tomography (PET/CT) protocol with [⁶⁸ Ga]Ga-FAPI-04 following [¹⁸F]FDG in patients presenting with negative or equivocal [¹⁸F]FDG.

Methods: Patients with negative or equivocal [¹⁸F]FDG findings underwent dual-tracer PET/CT (named FDG-mixed FAPI PET/CT, abbreviated to mFAPI PET/CT) on the same day, with [⁶⁸ Ga]Ga-FAPI-04 administered 4.0-7.75 h following [¹⁸F]FDG injection. Lesion detection rates and lesion-to-background uptake ratios (LBRs) were compared between [¹⁸F]FDG and mFAPI PET/CT.

Results: Forty-four patients were included in the analysis. The mFAPI PET was superior to [¹⁸F]FDG PET for primary tumour detection (86.2% [25/29] vs. 37.9% [11/29], P < 0.001), and showed higher LBRs (P < 0.001) in various types of cancer. For metastatic lesions detection, mFAPI PET yielded a greater number of positive lesions (90.3% [317/351] vs. 44.7% [157/351], P < 0.001) and higher LBRs than [¹⁸F]FDG in most lesions, especially in lymph node, peritoneal, and liver metastases (all P < 0.05). The mFAPI PET/CT scans had a prominent impact on patients with negative or equivocal [¹⁸F]FDG in different clinical situations, including characterizing suspicious lesions in 88.9% (8/9), locating the primary site in 46.2% (6/13), upgrading of tumour staging in 81.8% (9/11), and identification of recurrence in 81.8% (9/11).

Conclusions: A same-day dual-tracer PET/CT protocol with [⁶⁸ Ga]Ga-FAPI-04 following [¹⁸F]FDG is feasible for enhancing the ability to identify indeterminate lesions, localize unknown malignant primary tumour sites, and accurately provide staging and restaging in patients presenting with negative or equivocal [¹⁸F]FDG.

Trial registration: NCT05034146. Registered February 23, 2021.

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.