Jinhui Wei, Kun Zou, Fangfang Sun, Qiaochu Feng, Haodong Liu, Hongna Zheng, Yanjie Guo, Longjie Li
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Comparisons were made between the ability of 18 F-FDG PET/CT and 18 F-FAPI-04 PET/CT to detect primary lesions and metastatic lymph nodes; semiquantitative PET/CT parameters were also analyzed, including SUV max , SUV mean , metabolic tumor volume (MTV for 18 F-FDG) and fibroblast tumor volume (FTV for 18 F-FAPI-04), tumor lesion glycolysis (TLG for 18 F-FDG) and tumor lesion FAPI (TLF for 18 F-FAPI-04), and tumor-to-background ratios (TBR liver and TBR blood ), calculated by dividing the SUV max of the lesion by the SUV mean of normal liver or blood pool.</p><p><strong>Results: </strong>18 F-FAPI-04 PET/CT identified a greater number of primary lesions and metastatic lymph nodes compared with 18 F-FDG PET/CT. 18 F-FAPI-04 PET/CT detected 19/19 primary tumors, achieving a detection rate of 100%, while 18 F-FDG PET/CT identified 18/19 primary tumors, with a detection rate of 95%. The PPV for both tracers was 100%, the NPV for 18 F-FDG PET/CT was 0%. For metastatic lymph nodes, 18 F-FAPI-04 PET/CT detected 82 nodes in 7 patients, while 18 F-FDG PET/CT detected 44 nodes in the same 7 patients. TBR was significantly higher for 18 F-FAPI-04 PET/CT compared with 18 F-FDGPET/CT for primary lesions (TBR blood : 16.33 vs 9.83, P = 0.005; TBR liver : 21.59 vs 7.04, P < 0.0001) and metastatic lymph nodes (TBR blood : 9.16 vs 7.64, P = 0.033; TBR liver : 10.38 vs 5.29, P < 0.0001). No significant differences were observed in other semiquantitative parameters.</p><p><strong>Conclusions: </strong>18 F-FAPI-04 PET/CT had superior performance in detecting primary lesions and metastatic lymph nodes in cervical cancer compared with 18 F-FDG PET/CT. 18 F-FAPI-04 exhibited lower uptake in normal tissues, leading to a higher TBR. These findings imply that 18 F-FAPI-04 PET/CT has potential for clinical application in cervical cancer.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"983-991"},"PeriodicalIF":9.6000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502941/pdf/","citationCount":"0","resultStr":"{\"title\":\"18 F-FAPI-04 PET/CT in the Evaluation of Patients With Cervical Cancers : Head-to-Head Comparison With 18 F-FDG PET/CT.\",\"authors\":\"Jinhui Wei, Kun Zou, Fangfang Sun, Qiaochu Feng, Haodong Liu, Hongna Zheng, Yanjie Guo, Longjie Li\",\"doi\":\"10.1097/RLU.0000000000006103\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To explore the potential utility of 18 F-AlF-NOTA-fibroblast activation protein inhibitor (FAPI)-04 PET/CT (denoted as 18 F-FAPI-04 PET/CT) in the evaluation of cervical cancer through a head-to-head comparison with 18 F-FDG PET/CT for detecting primary tumors and metastatic lymph nodes.</p><p><strong>Patients and methods: </strong>A total of 22 patients with a pathologic diagnosis of cervical cancer underwent 18 F-FDG PET/CT and 18 F-FAPI-04 PET/CT within a 7-day period. Out of the 22 patients, 19 (median age, 62.3 y) were included in the final analysis. Comparisons were made between the ability of 18 F-FDG PET/CT and 18 F-FAPI-04 PET/CT to detect primary lesions and metastatic lymph nodes; semiquantitative PET/CT parameters were also analyzed, including SUV max , SUV mean , metabolic tumor volume (MTV for 18 F-FDG) and fibroblast tumor volume (FTV for 18 F-FAPI-04), tumor lesion glycolysis (TLG for 18 F-FDG) and tumor lesion FAPI (TLF for 18 F-FAPI-04), and tumor-to-background ratios (TBR liver and TBR blood ), calculated by dividing the SUV max of the lesion by the SUV mean of normal liver or blood pool.</p><p><strong>Results: </strong>18 F-FAPI-04 PET/CT identified a greater number of primary lesions and metastatic lymph nodes compared with 18 F-FDG PET/CT. 18 F-FAPI-04 PET/CT detected 19/19 primary tumors, achieving a detection rate of 100%, while 18 F-FDG PET/CT identified 18/19 primary tumors, with a detection rate of 95%. The PPV for both tracers was 100%, the NPV for 18 F-FDG PET/CT was 0%. For metastatic lymph nodes, 18 F-FAPI-04 PET/CT detected 82 nodes in 7 patients, while 18 F-FDG PET/CT detected 44 nodes in the same 7 patients. TBR was significantly higher for 18 F-FAPI-04 PET/CT compared with 18 F-FDGPET/CT for primary lesions (TBR blood : 16.33 vs 9.83, P = 0.005; TBR liver : 21.59 vs 7.04, P < 0.0001) and metastatic lymph nodes (TBR blood : 9.16 vs 7.64, P = 0.033; TBR liver : 10.38 vs 5.29, P < 0.0001). No significant differences were observed in other semiquantitative parameters.</p><p><strong>Conclusions: </strong>18 F-FAPI-04 PET/CT had superior performance in detecting primary lesions and metastatic lymph nodes in cervical cancer compared with 18 F-FDG PET/CT. 18 F-FAPI-04 exhibited lower uptake in normal tissues, leading to a higher TBR. 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引用次数: 0
摘要
背景：通过与18 F-FDG PET/CT检测原发性肿瘤和转移性淋巴结的头对头比较，探讨18 f - alf - nota -成纤维细胞活化蛋白抑制剂(FAPI)-04 PET/CT（简称18 F-FAPI-04 PET/CT）在宫颈癌评估中的潜在应用价值。患者和方法：22例病理诊断为宫颈癌的患者在7天内接受了18例F-FDG PET/CT和18例F-FAPI-04 PET/CT检查。在22例患者中，19例（中位年龄62.3岁）被纳入最终分析。比较18 F-FDG PET/CT与18 F-FAPI-04 PET/CT对原发性病变和转移性淋巴结的检测能力；同时分析半定量PET/CT参数，包括SUV max、SUV平均值、代谢肿瘤体积（18 F-FDG的MTV）和成纤维细胞肿瘤体积（18 F-FAPI-04的FTV）、肿瘤病变糖酵解（18 F-FDG的TLG）和肿瘤病变FAPI (18 F-FAPI-04的TLF)，以及肿瘤与背景比（TBR肝脏和TBR血液），计算方法是将病变的SUV max除以正常肝脏或血液池的SUV平均值。结果：与18 F-FDG PET/CT相比，18 F-FAPI-04 PET/CT发现了更多的原发性病变和转移性淋巴结。18个F-FAPI-04 PET/CT检出19/19个原发肿瘤，检出率100%，18个F-FDG PET/CT检出18/19个原发肿瘤，检出率95%。两种示踪剂的PPV均为100%，18 F-FDG PET/CT的NPV为0%。对于转移性淋巴结，18个F-FAPI-04 PET/CT在7例患者中检测到82个淋巴结，而18个F-FDG PET/CT在7例患者中检测到44个淋巴结。与18 F-FAPI-04 PET/CT相比，18 F-FDGPET/CT对原发性病变（TBR血：16.33 vs 9.83, P = 0.005； TBR肝：21.59 vs 7.04, P < 0.0001）和转移性淋巴结（TBR血：9.16 vs 7.64, P = 0.033； TBR肝：10.38 vs 5.29, P < 0.0001）的TBR明显更高。其他半定量参数无显著差异。结论：18 F-FAPI-04 PET/CT对宫颈癌原发病变和转移淋巴结的检测效果优于18 F-FDG PET/CT。18 F-FAPI-04在正常组织中表现出较低的摄取，导致更高的TBR。提示18f - fapi -04 PET/CT在宫颈癌诊断中具有潜在的临床应用价值。
18 F-FAPI-04 PET/CT in the Evaluation of Patients With Cervical Cancers : Head-to-Head Comparison With 18 F-FDG PET/CT.
Background: To explore the potential utility of 18 F-AlF-NOTA-fibroblast activation protein inhibitor (FAPI)-04 PET/CT (denoted as 18 F-FAPI-04 PET/CT) in the evaluation of cervical cancer through a head-to-head comparison with 18 F-FDG PET/CT for detecting primary tumors and metastatic lymph nodes.
Patients and methods: A total of 22 patients with a pathologic diagnosis of cervical cancer underwent 18 F-FDG PET/CT and 18 F-FAPI-04 PET/CT within a 7-day period. Out of the 22 patients, 19 (median age, 62.3 y) were included in the final analysis. Comparisons were made between the ability of 18 F-FDG PET/CT and 18 F-FAPI-04 PET/CT to detect primary lesions and metastatic lymph nodes; semiquantitative PET/CT parameters were also analyzed, including SUV max , SUV mean , metabolic tumor volume (MTV for 18 F-FDG) and fibroblast tumor volume (FTV for 18 F-FAPI-04), tumor lesion glycolysis (TLG for 18 F-FDG) and tumor lesion FAPI (TLF for 18 F-FAPI-04), and tumor-to-background ratios (TBR liver and TBR blood ), calculated by dividing the SUV max of the lesion by the SUV mean of normal liver or blood pool.
Results: 18 F-FAPI-04 PET/CT identified a greater number of primary lesions and metastatic lymph nodes compared with 18 F-FDG PET/CT. 18 F-FAPI-04 PET/CT detected 19/19 primary tumors, achieving a detection rate of 100%, while 18 F-FDG PET/CT identified 18/19 primary tumors, with a detection rate of 95%. The PPV for both tracers was 100%, the NPV for 18 F-FDG PET/CT was 0%. For metastatic lymph nodes, 18 F-FAPI-04 PET/CT detected 82 nodes in 7 patients, while 18 F-FDG PET/CT detected 44 nodes in the same 7 patients. TBR was significantly higher for 18 F-FAPI-04 PET/CT compared with 18 F-FDGPET/CT for primary lesions (TBR blood : 16.33 vs 9.83, P = 0.005; TBR liver : 21.59 vs 7.04, P < 0.0001) and metastatic lymph nodes (TBR blood : 9.16 vs 7.64, P = 0.033; TBR liver : 10.38 vs 5.29, P < 0.0001). No significant differences were observed in other semiquantitative parameters.
Conclusions: 18 F-FAPI-04 PET/CT had superior performance in detecting primary lesions and metastatic lymph nodes in cervical cancer compared with 18 F-FDG PET/CT. 18 F-FAPI-04 exhibited lower uptake in normal tissues, leading to a higher TBR. These findings imply that 18 F-FAPI-04 PET/CT has potential for clinical application in cervical cancer.
期刊介绍：
Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty.
Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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