^(68)Ga-FAPI-04 PET/CT对胰腺癌的诊断价值及对肿瘤分期的影响

^(68)Ga-labeled fibroblast activation protein inhibitor(FAPI)-04 PET/CT in the diagnosis of pancreatic cancer and its influence on clinical staging

目的:探讨^(68)Ga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^(68)Ga-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^(68)Ga-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。^(68)Ga-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(standard 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,^(68)Ga-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:^(68)Ga-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。

Objective:To investigate the diagnostic value of^(68)Ga-fibroblast activation protein inhibitor(FAPI)-04 positron emission tomography 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^(68)Ga-FAPI-04 PET/CT.Diagnostic value of^(68)Ga-FAPI-04 PET/CT in primary and metastatic pancreatic cancers was analyzed using pathological findings or follow-up images as the gold standard.The effect of^(68)Ga-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^(68)Ga-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^(68)Ga-FAPI PET/CT than in 3.94%(5/127)who underwent conventional CT;consequently,some patients changed their treatment plan.Conclusions:^(68)Ga-FAPI-04 PET/CT has high diagnostic sensitivity 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.