Diagnostic and prognostic value of 68Ga-FAPI PET for malignant tumors of the liver and biliary tract
10.3760/cma.j.cn321828-20230410-00099
- VernacularTitle:68Ga-FAPI PET对肝脏及胆道恶性肿瘤的诊断及预后价值
- Author:
Chunxia QIN
1
;
Yuhu LYU
;
Yangmeihui SONG
;
Yongkang GAI
;
Weiwei RUAN
;
Xiao ZHANG
;
Mengting LI
;
Fang LIU
;
Xiaoli LAN
Author Information
1. 华中科技大学同济医学院附属协和医院核医学科、分子影像湖北省重点实验室，武汉 430022
- Keywords:
Liver neoplasms;
Biliary tract neoplasms;
Quinolines;
Gallium radioisotopes;
Positron-emission tomography
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2023;43(6):337-342
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic and prognostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for hepatobiliary malignancies. Methods:From July 2020 to February 2023, 33 patients (23 males, 10 females; age (55.4±13.5) years) with suspected or confirmed liver or biliary tract malignancies who underwent 68Ga-FAPI PET in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. PET images were evaluated by 3 experienced nuclear medicine physicians, and the results of biopsy or postoperative pathology, clinical and imaging follow-up were used as the gold standard. One-way analysis of variance and least significant difference t test were used to compare the differences among groups. Survival analysis was performed using Kaplan-Meier curves and the log-rank test. Results:Of 33 patients, 14 performed PET for initial diagnosis and staging, and 19 for restaging. There were 14 patients with hepatocellular carcinoma (HCC), 13 patients with cholangiocarcinoma (CCA), and 6 patients with gallbladder carcinoma (GBC). The primary tumor of HCC, CCA and GBC all showed significant 68Ga-FAPI uptake, with no statistically significant difference in SUV max among groups ( F=1.58, P=0.250). The sensitivities of 68Ga-FAPI PET for initial diagnosis and restaging of hepatobiliary malignancies were 14/14 and 15/15, respectively. Compared with conventional imaging, 68Ga-FAPI PET changed the diagnosis and staging in 29.2%(7/24) patients. The treatment strategy was changed in 30.3%(10/33) patients with malignant tumors due to 68Ga-FAPI PET findings. Follow-up showed 22 cases survived and 11 cases died, with the overall survival of 355.56(80.00, 516.97) d, and 1- and 2-year survival rates were 68.2% and 57.9%, respectively. Semi-quantitative 68Ga-FAPI PET parameters such as SUV max, target-liver ratio (TLR), and target-blood ratio (TBR) had no significant prognostic value, but the prognosis of the group without distant metastases diagnosed by 68Ga-FAPI PET was significantly better than that of the group with distant metastasis ( P=0.032). Conclusion:68Ga-FAPI PET has high sensitivity for the diagnosis of hepatobiliary malignancies, which can help guide treatment decisions and prognosis evaluation.
