^(18)F-FAPI与^(18)F-FDG PET/CT在腹膜癌诊断中的价值对比

Head-to-head comparison of ^(18)F-FAPI and ^(18)F-FDG PET/CT in diagnosing peritoneal carcinoma

目的比较^(18)F-FAPI PET/CT与^(18)F-FDG PET/CT检查对腹膜癌的诊断效能。方法选取2020-11-01-2022-08-31广州医科大学附属第一医院收治的42例腹膜癌患者作为研究对象。其中,男13例,女29例;中位年龄为61岁(53.75~68.00岁);包括胃癌12例,卵巢癌10例,结直肠癌9例,肝癌5例,肺癌2例,胰腺癌1例,十二指肠癌1例,肾癌1例,原发性腹膜癌1例。所有患者均进行^(18)F-FAPI和^(18)F-FDG全身PET/CT显像检查。根据对同1个患者的2次PET/CT显像结果统计腹膜癌的检出率、最大标准摄取值(SUV_(max))和腹膜癌指数,并使用配对样本t检验比较2种检查结果。结果^(18)F-FAPI PET/CT对腹膜癌的检出率(100.0%)高于^(18)F-FDG PET/CT(73.8%),P<0.001。根据半定量分析,42例腹膜癌患者^(18)F-FAPI PET/CT的SUV_(max)[7.1(5.0~11.5)]高于^(18)F-FDG PET/CT[4.8(0.4~6.5)],t=6.498,P<0.001;卵巢癌和胃癌腹膜转移患者在^(18)F-FAPI PET/CT图像的SUV_(max)高于^(18)F-FDG PET/CT(t=6.165,P<0.001;t=4.747,P=0.001)。根据视觉评估,^(18)F-FAPI PET/CT图像中腹膜癌病灶的腹膜癌指数[18.0(9.0~27.0)]高于^(18)F-FDG PET/CT[8.5(2.0~25.5)],t=4.378,P<0.001。结论^(18)F-FAPI PET/CT对腹膜癌的诊断效能优于^(18)F-FDG PET/CT,尤其对胃癌和卵巢癌的腹膜转移瘤。

Objective To evaluate and compare the diagnostic efficacy of^(18)F-FAPI PET/CT and^(18)F-FDG PET/CT examinations in detecting peritoneal carcinomatosis(PC).Methods Totally 42 PC patients were enrolled based on histopathological findings,typical radiological appearances,and clinical imaging follow-up,including 13 males and 29 females.The median age was 61 years(53.75-68.00 years).Tumor type:12 gastric cancer,10 ovarian cancer,9 colorectal cancer,5 liver cancer,2 lung cancer,1 pancreatic cancer,1 duodenal cancer,1 renal cancer,and 1 primary peritoneal cancer.All patients underwent whole-body PET/CT imaging by using^(18)F-FAPI and^(18)F-FDG tracers.The detection rate and(maximum standardized uptake value,SUV_(max))of PC and PCI were determined by analyzing both two PET/CT images of each patient.A head-to-head comparison was conducted using the independent-sample t test.Results The detection rate of^(18)F-FAPI PET/CT in PC was significantly higher than in^(18)F-FDG PET/CT(P<0.001).In semi-quantitative analysis,the SUV_(max)of^(18)F-FAPI PET/CT was significantly higher than^(18)F-FDG PET/CT(t=6.498,P<0.001).Among them,the SUV_(max)of^(18)F-FAPI PET/CT in patients with peritoneal metastases from ovarian and gastric cancers was significantly higher than^(18)F-FDG PET/CT(ovarian cancer:t=6.165,P<0.001;gastric cancer:t=4.747,P=0.001).In visual analysis,the PCI of peritoneal cancer lesions in^(18)F-FAPI PET/CT images was significantly higher than that in^(18)F-FDG PET/CT(t=4.378,P<0.001).Conclusion The diagnostic efficiency of^(18)F-FAPI PET/CT is demonstrated to be superior to that of 18F-FDG PET/CT in the diagnosis of peritoneal carcinomas,particularly in cases of peritoneal metastases originating from gastric and ovarian cancers.