^(18)F-FDG和^(68)Ga-FAPI PET/CT在不同恶性肿瘤肺转移诊断中的对比研究  

Comparison of^(18)F-FDG and^(68)Ga-FAPI PET/CT in the diagnosis of lung metastasis in different malignant tumors

作　　者：杨梓怡 顾丙新 许晓平[1,2,3,4,5] 宋少莉 YANG Ziyi;GU Bingxin;XU Xiaoping;SONG Shaoli(Department of Nuclear Medicine,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Center for Biomedical Imaging,Fudan University,Shanghai 200032,China;Shanghai Engineering Research Center of Molecular Imaging Probes,Shanghai 200032,China;Department of Nuclear Medicine,Shanghai Proton and Heavy Ion Center,Shanghai 201315,China;Key Laboratory of Nuclear Physics and Ion-beam Application(MOE),Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学附属肿瘤医院核医学科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学生物医学影像研究中心,上海200032 [3]上海分子影像探针工程技术研究中心,上海200032 [4]上海市质子重离子医院核医学科,上海201315 [5]复旦大学核物理与离子束应用教育部重点实验室,上海200433

出　　处：《中国癌症杂志》2023年第9期829-833,共5页China Oncology

基　　金：上海市抗癌协会“翱翔”计划(HYXH2021004);浦东新区科技发展基金(PKL2020-Y55)。

摘　　要：背景与目的:^(18)F-氟代脱氧葡萄糖(^(18)F-flurodeoxyglucose,^(18)F-FDG)正电子发射计算机体层成像(positron emission tomography and computed tomography,PET/CT)是诊断恶性肿瘤伴远处转移的常用方法,但对肺部转移灶尤其是小病灶的检测仍不理想。^(68)Ga-成纤维细胞激活蛋白抑制剂(^(68)Ga-labeled fibroblast activation protein inhibitors,^(68)Ga-FAPI)已被用于靶向成纤维细胞激活蛋白和肿瘤基质的可视化。^(68)Ga-FAPI PET/CT对大多数癌症的原发灶及其转移灶的诊断价值均高于^(18)F-FDG,但至今尚未见到对恶性肿瘤肺部转移性病变的对比研究。因此,本研究旨在探讨^(18)F-FDG和^(68)Ga-FAPI PET/CT对不同恶性肿瘤肺转移病变的诊断价值。方法:回顾性分析复旦大学附属肿瘤医院2020年5月—2022年3月于1周内行^(18)F-FDG和^(68)Ga-FAPI PET/CT检查的20例恶性肿瘤肺转移患者的临床、病理学及影像学资料,其中上皮源性恶性肿瘤(癌)11例,间叶源性恶性肿瘤(肉瘤)9例。采用配对t检验比较^(68)Ga-FAPI和^(18)F-FDG的病灶最大标准摄取值(maximum standard uptake value,SUVmax)和肿瘤与本底比值(target-to-background ratio,TBR)参数之间的差异;采用线性相关性分析SUVmax和TBR与肺转移灶短径之间的相关性。结果:20例患者共81个肺转移灶(51个来自癌转移,30个来自肉瘤转移),^(18)F-FDG检出阳性病灶72个,^(68)Ga-FAPI检查阳性病灶70个。与^(68)Ga-FAPI相比,肺转移灶^(18)F-FDG摄取值更高,尤其是癌来源的肺转移病灶(P<0.001)。线性相关性分析结果显示,两种显像探针的半定量代谢参数值与肺转移病灶短径之间呈正相关(P<0.001)。结论:^(68)Ga-FAPI在检测恶性肿瘤肺转移病变时并无明显优势,尤其是在上皮组织来源的恶性肿瘤肺转移诊断中,^(18)F-FDG摄取值往往更高。Background and purpose:^(18)F-flurodeoxyglucose(^(18)F-FDG)positron emission tomography and computed tomography(PET/CT)is a common method for the diagnosis of malignant tumors with distant metastases.However the detection of lung metastases,especially small lesions,is still unsatisfactory.^(68)Ga-labeled fibroblast activation protein inhibitors(^(68)Ga-FAPI)have been used to target fibroblast activating proteins and visualize tumor stroma.The diagnostic value of^(68)Ga-FAPI PET/CT is higher than that of^(18)F-FDG in the primary sites and metastases of most cancers,but no comparative study has been seen in lung metastases of malignant tumors.Therefore,this study aimed to investigate the diagnostic value of^(18)F-FDG and^(68)Ga-FAPI PET/CT in different malignant lung metastases.Methods:The clinical,pathological and imaging data of 20 patients with lung metastasis who underwent^(18)F-FDG and^(68)Ga-FAPI PET/CT examination within one week in Fudan University Shanghai Cancer Center from May 2020 to March 2022 were retrospectively analyzed.Among them,11 cases were epithelial malignant tumors(carcinoma),and 9 cases were mesophyll malignant tumors(sarcoma).The semi-quantitative metabolic parameters including maximum standard uptake value(SUVmax)and target-to-background ratio(TBR)of^(68)Ga-FAPI and^(18)F-FDG were compared by paired t test.The linear correlation between SUVmax and TBR and the short diameter of lung metastasis were analyzed.Results:A total of 81 lung metastases(51 carcinomas and 30 sarcomas)were detected in 20 patients,72 positive lesions were detected by^(18)F-FDG and 70 positive lesions by^(68)Ga-FAPI.Compared with^(68)Ga-FAPI,^(18)F-FDG uptake was higher in lung metastases,especially those of carcinoma(P<0.001).The results of linear correlation analysis showed that the semi-quantitative metabolic parameters of the two imaging probes were positively correlated with the short diameter of lung metastases(P<0.001).Conclusion:^(68)Ga-FAPI has no obvious advantage in the detection of lung metastases from malig

关 键 词：恶性肿瘤 肺转移 正电子发射计算机体层成像 ^(18)F-氟代脱氧葡萄糖 ^(68)Ga-成纤维细胞激活蛋白抑制剂 

分 类 号：R730.44[医药卫生—肿瘤]