68Ga-labeled fibroblast activation protein inhibitor(FAPI)-04 PET/CT in the diagnosis of pancreatic cancer and its influence on clinical staging
华俊 1李岚 2杨媛媛 1刘琪 1张伟 1陈晓良1
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作者信息
1. 重庆大学附属肿瘤医院核医学科(重庆市 400030)
2. 重庆大学附属肿瘤医院放射科(重庆市 400030)
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摘要
目的:探讨68Ga标记的成纤维细胞激活蛋白抑制剂(fibroblast activation protein inhibitor,FAPI)-04正电子发射断层显像/X线计算机体层成像(positron emission tomography and computed tomography,PET/CT)对初诊胰腺癌的诊断价值及对肿瘤分期的影响.方法:回顾性收集 2021年 8月至 2023年 8月于重庆大学附属肿瘤医院就诊的 134例因怀疑胰腺占位的患者临床及影像资料.分析68Ga-FAPI-04 PET/CT 对胰腺癌原发灶及转移灶的诊断价值;并与传统CT比较,分析68Ga-FAPI-04 PET/CT对胰腺癌肿瘤分期的影响.结果:共计纳入 134例患者,其中胰腺癌 127例,良性病变 7例.68Ga-FAPI-04 PET/CT对胰腺癌原发灶、区域淋巴结及远处转移灶检出率分别为 100%(127/127)、68.63%(35/51),95.35%(41/43).胰腺癌中位最大标准化摄取值(stand-ard uptake value maxium,SUVmax)为 14.92,高于胰腺良性病变中位SUVmax(6.1)(Z=-2.921,P=0.003).与传统CT比较,68Ga-FAPI PET/CT检查后共有 32.28%(41/127)胰腺癌患者TNM分期发生改变.3.94%(5/127)患者改变了治疗方案.结论:68Ga-FAPI-04 PET/CT对胰腺癌原发灶诊断具有较高的敏感性,较传统CT可发现更多远处转移病灶,改善患者M分期,有助于全面评估全身肿瘤负荷、制定治疗计划.
Abstract
Objective:To investigate the diagnostic value of 68Ga-fibroblast activation protein inhibitor(FAPI)-04 positron emission tomo-graphy and computed tomography(PET/CT)in patients with newly diagnosed pancreatic cancer and its impact on the initial tumor,node,metastasis(TNM)and clinical stagings.Methods:Clinical and imaging data of patients suspected of having pancreatic lesions and admitted to Chongqing University Cancer Hospital between August 2021 and August 2023 were analyzed retrospectively.All the patients underwent conventional CT and 68Ga-FAPI-04 PET/CT.Diagnostic value of 68Ga-FAPI-04 PET/CT in primary and metastatic pancreatic cancers was ana-lyzed using pathological findings or follow-up images as the gold standard.The effect of 68Ga-FAPI-04 PET/CT on TNM and clinical stagings of pancreatic cancer was analyzed and compared with that of conventional CT.Results:A total of 134 patients were included in the study:127 with pancreatic cancers and 7 with benign lesions.Detection rates of 68Ga-FAPI-04 PET/CT for primary pancreatic cancers,regional lymph node metastasis,and distant metastasis were 100%(127/127),68.63%(35/51),and 95.35%(41/43),respectively.Median standard uptake value maxium(SUVmax)of pancreatic cancers(14.9)was significantly higher than that of benign pancreatic lesions(6.1)(Z value =-2.921,P= 0.003).TNM staging changed in 32.28%(41/127)pancreatic cancer patients after 68Ga-FAPI PET/CT than in 3.94%(5/127)who underwent conventional CT;consequently,some patients changed their treatment plan.Conclusions:68Ga-FAPI-04 PET/CT has high diagnostic sensitiv-ity for pancreatic cancer and can detect more cases of distant metastatic lesions and improve M staging compared to that by conventional CT,thereby facilitating a more comprehensive assessment of systemic tumor burden and treatment planning.
关键词
成纤维细胞激活蛋白抑制剂/胰腺癌/正电子发射断层显像/X线电子计算机断层扫描
Key words
fibroblast activation protein inhibitor(FAPI)/pancreatic cancer/positron emission tomography(PET)/computed tomo-graphy(CT)
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