Head-to-head comparison of diagnostic efficacy of 18F-FAPI-42 and 18F-FDG PET/CT in bone metastasis of malignant tumors
10.3760/cma.j.cn321828-20240922-00330
- VernacularTitle:头对头比较 18F-FAPI-42与 18F-FDG PET/CT对恶性肿瘤骨转移的诊断效能
- Author:
Zhiyi LAN
1
;
Ying TIAN
1
;
Kemin ZHOU
1
;
Hongsheng LI
1
;
Wenlan ZHOU
1
;
Ye DONG
1
;
Yin ZHANG
1
;
Li CHEN
1
;
Hubing WU
1
Author Information
1. 南方医科大学南方医院PET中心，广州 510515
- Publication Type:Journal Article
- Keywords:
Neoplasm metastasis;
Skeleton;
Antagonists and inhibitors;
Membrane proteins;
Fibroblasts;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorode
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(10):577-582
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI)-42 PET/CT and 18F-FDG PET/CT for bone metastasis in patients with malignant tumors. Methods:From January 2022 to October 2023, the data of 238 patients (160 males, 78 females; age: 58(50, 66) years) with various malignant tumors who underwent both 18F-FAPI-42 and 18F-FDG PET/CT imaging at Nanfang Hospital, Southern Medical University were retrospectively reviewed. An abnormal focal radioactive uptake in bones on the PET images was considered as positive lesion for bone metastasis. The efficacy of 2imaging methods and the supplementary role of CT in the diagnosis of bone metastasis were evaluated by McNemar test. Results:Of 238 patients, 95 were with bone metastases and 143 were without bone metastases, including 436 lesions with bone metastases and 358 lesions without bone metastases. Based on the visual analysis, 18F-FAPI-42 PET showed a higher diagnostic sensitivity than 18F-FDG PET (98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001), while 18F-FDG PET had a higher diagnostic specificity than 18F-FAPI-42 PET (83.2%(298/358) vs 70.4%(252/358); χ2=22.50, P<0.001), and the accuracies of both methods were similar (85.8%(681/794) vs 85.0%(675/794); χ2=0.16, P=0.685). However, when the positive lesions seen in PET were analyzed combined with the image features on CT by the same scanner, the diagnostic specificity of 18F-FAPI-42 PET/CT was significantly improved compared to that of 18F-FAPI-42 PET alone (91.3%(327/358) vs 70.4%(252/358); χ2=73.01, P<0.001), and was similar to 18F-FDG PET/CT (93.0%(333/358); χ2=0.78, P=0.377). Meanwhile, this combined analysis brought a higher sensitivity and accuracy of 18F-FAPI-42 PET/CT than 18F-FDG PET/CT in diagnosing bone metastases (sensitivity: 98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001; accuracy: 95.2%(756/794) vs 89.4%(710/794); χ2=21.54, P<0.001). Conclusions:The diagnostic sensitivity of 18F-FAPI-42 PET for bone metastasis is superior to 18F-FDG PET, but the specificity is lower. However, when CT features is combined for analysis, the diagnostic specificity of 18F-FAPI-42 PET/CT is significantly improved, which thus can be used to diagnose bone metastasis accurately and is superior to 18F-FDG PET/CT.
