对比^(18)F-NOTA-FAPI-04与^(18)F-FDGPET/CT显像诊断腹膜转移癌

Comparison on ^(18)F-NOTA-FAPI-04 and ^(18)F-FDG PET/CT imaging for diagnosing peritoneal carcinomatosis

目的对比^(18)F-成纤维细胞激活蛋白抑制剂(FAPI)-04与^(18)F-FDG PET/CT诊断腹膜转移癌(PC)的价值。方法前瞻性纳入42例疑诊PC患者行全身^(18)F-1,4,7-三氮杂环壬烷-N,N′,N″-三乙酸(NOTA)-FAPI-04和^(18)F-FDG PET/CT检查,以病理学结果为金标准,比较2种显像的PC指数(PCI)、病灶最大标准摄取值(SUVmax)及靶-背景比(TBR)差异;绘制受试者工作特征曲线,评估2种显像诊断PC效能。结果42例中,病理确诊31例PC。^(18)F-NOTA-FAPI-04诊断PC的敏感度、特异度和准确率分别为93.55%、72.73%和88.10%,^(18)F-FDG PET/CT分别为74.19%、54.55%和69.05%,前者的敏感度及准确率均高于后者(P均<0.05);以前者所获PCI、所测PC的SUVmax、TBR均高于后者(P均<0.001)。分别以2.31及2.52为FAPI-SUVmax、FDG-SUVmax的截断值,^(18)F-NOTA-FAPI-04及^(18)F-FDG PET/CT诊断PC的曲线下面积(AUC)分别为0.839及0.630,差异有统计学意义(P=0.002);分别以1.60及0.73为FAPI-TBR、FDG-TBR的截断值,^(18)F-NOTA-FAPI-04及^(18)F-FDG PET/CT诊断PC的AUC分别为0.856及0.604,差异亦有统计学意义(P=0.005)。结论^(18)F-NOTA-FAPI-04 PET/CT诊断PC较^(18)F-FDG PET/CT更具优势。

Objective To compare the value of ^(18)F-fibroblast activation protein inhibitor(FAPI)-04 and ^(18)F-FDG PET/CT for diagnosing peritoneal carcinomatosis(PC).Methods Totally 42 patients with suspected PC who underwent whole body ^(18)F-1,4,7-triazacyclononane-N,N′,N″-triacetic acid(NOTA)-FAPI-04 and ^(18)F-FDG PET/CT imaging sequentially were prospectively enrolled.Taken histopathological results as the gold standards,PC index(PCI),the maximum standard uptake value(SUV max)and target-to-back ground ratio(TBR)were compared between 2 kinds of images.The receiver operating characteristic curves were drawn,and the efficacy of 2 kinds of images for diagnosing PC were evaluated.Results Pathological results proved 31 cases with PC.The sensitivity,specificity and accuracy of ^(18)F-NOTA-FAPI-04 for diagnosing PC was 93.55%,72.73% and 88.10%,respectively,of ^(18)F-FDG PET/CT was 74.19%,54.55% and 69.05%,respectively.The sensitivity and accuracy of the former for diagnosing PC were higher than those of the latter(both P<0.05),and PCI of 31 patients with PC calculated with the former was higher than that of the latter(P<0.001),SUV max and TBR of PC measured with the former were higher than those with the latter(both P<0.001).Taken 2.31 and 2.52 as the cut-off value of FAPI-SUV max and FDG-SUV max,respectively,the area under the curve(AUC)of ^(18)F-NOTA-FAPI-04 and ^(18)F-FDG PET/CT for diagnosing PC was 0.839 and 0.630,respectively,which was significantly different(P=0.002).Taken 1.60 and 0.73 as the cut-off value of FAPI-TBR and FDG-TBR,respectively,the AUC of ^(18)F-NOTA-FAPI-04 and ^(18)F-FDG PET/CT for diagnosing PC was 0.856 and 0.604,respectively,also being significantly different(P=0.005).Conclusion Compared with ^(18)F-FDG PET/CT,^(18)F-NOTA-FAPI-04 PET/CT was better for diagnosing PC.