Comparison of 18F-FAPI-42 and 18F-FDG PET/CT in Diagnosis and Staging of Primary Hepatic Tumours
10.3969/j.issn.1005-5185.2024.12.010
- VernacularTitle:18F-FAPI-42与18F-FDG PET/CT在原发性肝癌诊断和分期中的应用比较
- Author:
Miao KE
1
;
Jing ZHANG
1
;
Jie LV
1
;
Youcai LI
1
;
Kaixiang ZHONG
1
;
Peng HOU
1
;
Ruiyue ZHAO
1
;
Xinlu WANG
1
Author Information
1. 广州医科大学附属第一医院核医学科,广东 广州 510000
- Publication Type:Journal Article
- Keywords:
Carcinoma,hepatocellular;
Positron emission tomography computed tomography;
18F-FAPI-42;
18F-FDG;
Neoplasm staging;
Diagnosis
- From:
Chinese Journal of Medical Imaging
2024;32(12):1248-1255
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the diagnosis and staging performance of 18F-FAPI-42 PET/CT compared to 18F-FDG PET/CT in primary hepatic tumours. Materials and Methods We performed a retrospective study including all primary hepatic tumours patients who underwent both 18F-FAPI-42 and 18F-FDG PET/CT scans within two weeks at the First Affiliated Hospital of Guangzhou Medical University from October 2020 to May 2023. With histopathologic proof (surgical resection and/or percutaneous biopsies) or multimodality radiographic follow-up (CT/MRI-enhanced) as the final diagnostic reference standard. The maximum standard uptake value,tumor-to-background ratio and diagnostic rates (positive lesion/total lesion) between 18F-FAPI-42 and 18F-FDG were compared. Results Thirty-four primary hepatic tumours patients were enrolled in this study,including 27 hepatocellular carcinoma,5 intrahepatic cholangiocarcinoma and 2 combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma. It was found that 18F-FAPI-42 PET/CT significantly outperformed 18F-FDG in diagnosing intrahepatic lesions and lymph node metastases (intrahepatic lesions:93.33％ vs. 52.22％,P<0.001;lymph node metastases:100％ vs. 87.50％,P=0.021). The detection rates for distant metastases were comparable between the two radioactive tracers (100％ vs. 96.20％,P>0.05). 18F-FAPI-42 showed higher maximum standard uptake value and tumor-to-background ratio in intrahepatic lesions,regional lymph node metastases,bone and peritoneal metastases compared to 18F-FDG (Z=-5.261--1.183,all P<0.05). For primary hepatic tumours initial staging,18F-FAPI-42 PET/CT upstaged the T stage in 20.8％ (5/24) of patients,the N stage in 8.3％ (2/24) and the M stage in 8.3％ (2/24) of patients,consistent with multimodal imaging diagnostic results. The evaluation of post-treatment patient outcomes showed that 18F-FAPI-42 had a detection rate of 92.86％ (13/14) for hepatic tumours recurrence,higher than 18F-FDG (64.28％,9/14). 18F-FAPI-42 identified more recurrent primary lesions and intrahepatic metastatic foci,demonstrating greater sensitivity than 18F-FDG. Conclusion The diagnostic efficacy of 18F-FAPI-42 PET/CT for primary hepatic tumours is significantly better than 18F-FDG,showing excellent performance in the staging and restaging of primary hepatic tumours,which suggesting that the application of 18F-FAPI-42 is helpful to improve the clinical management of primary hepatic tumours patients.
