18F-FAPI PET/MR versus contrast-enhanced CT for evaluation of metachronous ovarian metastasis following gastric signet-ring cell carcinoma surgery
10.3760/cma.j.cn321828-20251016-00363
- VernacularTitle:18F-FAPI PET/MR与增强CT评估胃印戒细胞癌术后异时性卵巢转移的对比研究
- Author:
Tingting WANG
1
;
Gan HUANG
1
;
Cheng WANG
1
;
Haitao ZHAO
1
;
Liangrong WAN
1
;
Jianjun LIU
1
Author Information
1. 上海交通大学医学院附属仁济医院核医学科，上海 200127
- Publication Type:Journal Article
- Keywords:
Carcinoma, signet ring cell;
Neoplasm metastasis;
Ovarian neoplasms;
Membrane proteins;
Positron-emission tomography;
Tomography, X-ray computed;
Magnetic r
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(12):720-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI) PET/MR and contrast-enhanced CT in detecting metachronous ovarian metastasis after gastric signet-ring cell carcinoma (GSRCC) surgery, and to evaluate its impact on clinical decision-making. Methods:This study employed a diagnostic test design. A retrospective analysis was conducted on 26 female patients with suspected metachronous ovarian metastasis following GSRCC resection between January 2023 and June 2025 in Renji Hospital, Shanghai Jiao Tong University School of Medicine. All patients underwent both 18F-FAPI PET/MR and contrast-enhanced CT within 2 weeks. Using histopathology or clinical imaging follow-up (≥6 months) as the reference standard, the diagnostic performance of both modalities was compared (McNemar test, Fisher exact test and Delong test), and changes in clinical management were analyzed. Results:Metachronous ovarian metastasis was confirmed in 12 patients (22 lesions). 18F-FAPI PET/MR showed significantly higher sensitivity (90.9%(20/22) vs 72.7%(16/22); χ2=4.10, P=0.043), specificity (100%(30/30) vs 50.0%(15/30); χ2=13.01, P<0.001), and accuracy (96.2%(50/52) vs 59.6%(31/52); χ2=15.43, P<0.001), compared to contrast-enhanced CT, with a significantly higher AUC (0.964 vs 0.815; Z=2.85, P=0.015). It also demonstrated superior detection of extraovarian metastases, including anastomotic recurrence, peritoneal spread, and lymph node involvement ( P values: 0.004-0.031), and identified 5 additional rare-site metastases in 3 patients that were missed by contrast-enhanced CT. Based on 18F-FAPI PET/MR findings, clinical management was adjusted in 6 patients with metastasis. Conclusion:18F-FAPI PET/MR outperforms contrast-enhanced CT in diagnosing metachronous ovarian metastasis and performing whole-body restaging in post-surgical GSRCC patients, therapy provides critical evidence for informing decision-making.
