^(18)F-FDG和^(18)F-FAPI PET/CT在腹盆腔恶性肿瘤治疗后可疑复发的诊断价值比较研究  

Comparison of the diagnostic value of ^(18)F-FDG and ^(18)F-FAPI PET/CT for suspected recurrence of abdominal and pelvic malignant tumors after treatment

作　　者：王育珠 樊卫[2] 胡莹莹[2] WANG Yuzhu;FAN Wei;HU Yingying(Department of Nuclear Medicine,Gansu Hospital,Affiliated Cancer Hospital of Sun Yat-sen University,Lanzhou 730000,Gansu Province,China;Department of Nuclear Medicine,Sun Yat-sen University Cancer Centre,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]中山大学附属肿瘤医院甘肃医院核医学科,甘肃兰州730000 [2]中山大学肿瘤防治中心核医学科,广东广州510000

出　　处：《肿瘤影像学》2024年第5期515-522,共8页Oncoradiology

摘　　要：目的:比较^(18)F-氟代脱氧葡萄糖(flurodeoxyglucose,FDG)正电子发射体层成像(positron emission tomography,PET)/计算机体层成像(computed tomography,CT)和^(18)F-成纤维细胞活化蛋白抑制剂(fibroblast activation protein inhibitor,FAPI)PET/CT对腹盆腔恶性肿瘤治疗后临床怀疑复发/转移的诊断价值。方法:回顾并分析2021年9月—2024年2月就诊于中山大学肿瘤防治中心的腹盆腔恶性肿瘤治疗后临床怀疑肿瘤复发/转移患者的临床随访结果、病理学资料及^(18)F-FDG PET/CT、^(18)F-FAPI PET/CT显像结果,分别测量患者病灶最大标准摄取值(maximum standard uptake value,SUVmax)并计算肿瘤背景比值(tumor-to-background ratio,TBR),利用小提琴图及配对t检验统计分析两种显像剂的SUVmax及TBR,并计算各自的诊断效能。结果:64例(男性33例,女性31例)腹盆腔恶性肿瘤治疗后临床怀疑肿瘤复发/转移患者中52例被临床或病理学检查证实为转移。两种显像所示SUVmax差异无统计学意义(P>0.05),小提琴图中,^(18)F-FAPI PET/CT的SUVmax中位数高于^(18)F-FDG PET/CT显像,并且分布较为集中;TBR差异有统计学意义(P<0.0001),^(18)F-FAPI PET/CT TBR高于^(18)F-FDG PET/CT。^(18)F-FDG PET/CT和^(18)F-FAPI PET/CT诊断转移的灵敏度分别为55.8%(29/52)和88.5%(46/52),特异度为83.3%(10/12)和58.3%(7/12),准确度为60.9%(39/64)和82.8%(53/64)。结论:对于腹盆腔恶性肿瘤治疗后临床怀疑复发/转移的患者,^(18)F-FAPI PET/CT是优于^(18)F-FDG PET/CT的成像方式,特别是腹膜转移,^(18)F-FAPI PET/CT可作为^(18)F-FDG-PET/CT显像阴性时的补充方法,为临床医师提供更多信息。Obejective:To compare the diagnostic value of ^(18)F-flurodeoxyglucose(FDG)positron emission tomography(PET)/computed tomography(CT)and ^(18)F-fibroblast activation protein inhibitor(FAPI)PET/CT for patients with suspected recurrence of abdominal and pelvic malignant tumors after treatment.Methods:The clinical follow-up results,pathological data,and ^(18)F-FDG PET/CT and ^(18)F-FAPI PET/CT imaging results of patients with clinically suspected recurrence/metastasis of abdominal and pelvic malignant tumors after treatment who were admitted to the Sun Yat-sen University Cancer Centre from September 2021 to February 2024 were reviewed and analyzed.The patient’s medical history and clinical follow-up results were collected.The patient’s lesions were measured with the maximum standard uptake value(SUVmax)and calculated the tumor-to-background ratio(TBR).SUVmax and TBR were analyzed by Violin Plot and paired t-test.The diagnostic efficacy of ^(18)F-FDG PET/CT and ^(18)F-FAPI PET/CT was statistically compared.Results:Of the 64 patients(33 males,31 females)with clinically suspected recurrence/metastasis after treatment for abdominal and pelvic malignant tumors,52 had metastasis confirmed by clinical or pathological examination.There was no significant difference in SUVmax between the two images(P>0.05).In the Violin Plot,the median SUVmax of ^(18)F-FAPI PET/CT was higher than that of ^(18)F-FDG PET/CT,and the distribution was more concentrated.TBR was statistically significant(P<0.0001),and the TBR of ^(18)F-FAPI PET/CT was higher than that of ^(18)F-FDG PET/CT.The sensitivity of ^(18)F-FDG PET/CT and ^(18)F-FAPI PET/CT for diagnosing metastasis was 55.8%(29/52)and 88.5%(46/52),the specificity was 83.3%(10/12)and 58.3%(7/12),and the accuracy was 60.9%(39/64)and 82.8%(53/64),respectively.Conclusion:^(18)F-FAPI PET/CT is superior to ^(18)F-FDG PET/CT for patients with suspected recurrence of abdominal and pelvic malignant tumors after treatment,especially in peritoneal metastases,and can be used as a complementary metho

关 键 词：恶性肿瘤 腹盆腔 转移 正电子发射体层成像/计算机体层成像 ^(18)F-氟代脱氧葡萄糖 成纤维细胞活化蛋白抑制剂 

分 类 号：R445.6[医药卫生—影像医学与核医学]