68Ga-FAPI-04 PET/MR for predicting pathological complete response to neoadjuvant immunotherapy in patients with gastrointestinal cancer
10.3760/cma.j.cn321828-20241021-00357
- VernacularTitle:68Ga-FAPI-04 PET/MR预测新辅助免疫综合治疗后的胃肠道恶性肿瘤病理完全缓解
- Author:
Xiao ZHANG
1
;
Yuan FENG
1
;
Chunxia QIN
1
;
Yongkang GAI
1
;
Weiwei RUAN
1
;
Mengting LI
1
;
Xiaoli LAN
1
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
- Publication Type:Journal Article
- Keywords:
Gastrointestinal neoplasms;
Quinolines;
Isotope labeling;
Gallium radioisotopes;
Neoadjuvant therapy;
Immunotherapy;
Positron-emission tomography;
Magnetic r
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(3):144-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine if preoperative 68Ga-fibroblast activation protein inhibitor (FAPI)-04 PET/MR could contribute to predicting pathological complete response (pCR) in patients with gastrointestinal cancer undergoing neoadjuvant immunotherapy. Methods:In this retrospective study, 35 patients (23 males, 12 females, age (59.1±7.9) years) with gastrointestinal cancer who underwent 68Ga-FAPI-04 PET/MR after receiving neoadjuvant immunotherapy between February 2021 and January 2024 were enrolled. Clinical data, PET imaging parameters including SUV, peak of SUV normalized by lean body mass (SUL peak), FAPI-positive tumor volume (FTV), and total FAPI-positive lesion burden (TLF), and pathological data were collected and analyzed. Patients were divided into pCR group and non-pCR group, and the independent-sample t test or Mann-Whitney U test was performed to compare those parameters between the 2 groups. ROC curve analysis (Delong test) was performed to evaluate the diagnostic efficiency of each parameter to predict pCR. Results:The overall pCR rate of the neoadjuvant therapy was 40.0%(14/35). In the visual evaluation, 68Ga-FAPI-04 PET was limited in predicting pCR, showing false positivity in 12 patients and false negative in 1 patent. While SUV max( t=2.50, P=0.018), SUL peak( t=3.11, P=0.004), FTV( U=3.00, P=0.030) and TLF( U=2.96, P=0.042) in non-pCR group were all higher than those in pCR group. The predictive efficiency of FTV <1.925cm 3 for pCR was better than the efficiency of PET visual evaluation ( Z=3.61, P<0.001), with the prediction accuracy of 82.86%(29/35). Conclusions:68Ga-FAPI-04 PET/MR may provide an effective clinical tool for guiding further treatment of patients with gastrointestinal cancer undergoing neoadjuvant immunotherapy. The quantitative features derived from 68Ga-FAPI-04 PET appear promising in predicting pCR, which are expected to provide a reference for avoiding surgery.
