肝肿瘤对^(68)Ga-FAPI-04摄取能力研究

Uptake ability of ^(68)Ga-FAPI-04 in liver tumors

目的探讨不同肝肿瘤对^(68)Ga-FAPI-04的摄取能力,分析^(68)Ga-FAPI-04 PET/CT对肝肿瘤潜在的鉴别诊断价值。方法回顾分析2020-01-01-2022-09-30于西南医科大学附属医院疑诊为肝癌且接受^(68)Ga-FAPI-04 PET/CT检查的70例患者临床资料。根据术后病理学检查结果以及相关随访结果(超声、CT和MRI等)将病例分为肝原发肿瘤45例(肝细胞肝癌25例,胆管细胞癌16例,肝血管瘤4例),肝转移癌25例。原发性肝癌(肝细胞肝癌及胆管细胞癌)和肝转移癌之间最大标准摄取值(SUV_(max))采用独立样本t检验,肝细胞癌、胆管细胞癌和肝转移癌之间的SUV_(max)采用方差分析及事后多重比较分析,肝内病灶长径与SUV_(max)之间关系采用Pearson检验,检验各指标的诊断能力用接受者操作特征曲线(ROC)分析。结果原发性肝癌与肝转移癌对显像剂摄取能力比较,除了肝细胞肝癌与胆管细胞癌差异无统计学意义外(P=0.021),其余各组间差异均有统计学意义,均P<0.05。肝癌平均SUV_(max)最高的是胆管细胞癌(14.90±5.33),其次是肝细胞肝癌(9.98±4.92),最低的是肝转移癌(6.57±2.82)。肝血管瘤的平均SUV_(max)为1.45±0.14。在行^(68)Ga-FAPI-04 PET/CT的原发性肝癌及肝转移癌的66例患者中,SUV_(max)对于鉴别诊断原发性肝癌和肝转移癌的AUC值为0.809,分界值为7.600,灵敏度为0.756,特异度为0.720,约登指数为0.476。原发性肝癌病灶纵向直径与SUV_(max)值无关(r=0.200,P=0.211),肝转移癌病灶纵向直径与SUV_(max)值有关(r=0.570,P=0.003)。结论^(68)Ga-FAPI-04作为一种新的示踪剂,通过PET/CT显像在诊断肝癌方面具有较大潜力,在鉴别原发性肝癌、肝转移癌和良性病变方面也具有潜在的价值。

Objective To explore the uptake ability of^(68)Ga-FAPI-04by different liver tumors,and analyze the potential differential diagnostic value of^(68)Ga-FAPI-04PET/CT in liver tumors.Methods We analyzed the imaging data of 70 patients with suspected liver cancer in Affiliated Hospital of Southwest Medical University,retrospectively.All patients underwent^(68)Ga-FAPI-04PET/CT examination.We divided these patients into two groups according to the pathological results and imaging examination results,including 45primary liver tumor(25 hepatocellular carcinoma,16cholangiocarcinoma,4hemangioma)and 25liver metastases.The difference in SUV_(max)between primary liver cancer and liver metastasis was analyzed by independent sample t-test.The differences in SUV_(max)between hepatocellular carcinoma,cholangiocarcinoma,and liver metastasis were analyzed.The relationships between the length and diameter of intrahepatic lesions and SUV_(max)were analyzed by Pearson's test.The diagnostic ability of each indicator were analyzed by receiver operating characteristic curve(ROC)analysis.Results The difference was statistically significant between primary liver cancer(hepatocellular carcinoma and cholangiocarcinoma)and liver metastases in the uptake ability of imaging agents(P<0.05).There was no statistically significant difference in the uptake ability of imaging agents between hepatocellular carcinoma and cholangiocarcinoma.The cholangiocarcinoma group's liver lesion tracer uptake was the highest,the mean SUV_(max)was 14.90±5.33.The mean SUV_(max)for hepatocellular carcinoma group's lesion was 9.98±4.92.The mean SUV_(max)for hepatocellular carcinoma group's lesion was 6.57±2.82.Among the 66patients with primary liver cancer and liver metastases who underwent^(68)Ga-FAPI-04PET/CT,when the Youden index was 0.476,the SUV_(max)boundary value was 7.600.At this time,the corresponding sensitivity of^(68)Ga-FAPI-04PET/CT was 0.756,the specificity was 0.720.There was no relationship between the long diameter of primary liver cancer focus and the SUV_(max)(r=0.200,P=0.211).There was a significant correlation between the long diameter of liver metastases and the SUV_(max)(r=0.570,P=0.003).Conclusion As a new tracter,^(68)Ga-FAPI-04has great potential in the diagnosis of liver diseases,and it has potential value in distinguishing primary liver cancer,liver metastasis and benign lesions.