^(18)F-FAPI-42 PET/CT enhances the diagnostic efficacy for peritoneal metastasis of colorectal cancer and guides treatment decisions:an original retrospective study  

作　　者：Xuneng Zhang Rongqin Zhang Qingyang Zheng Zichuan He Bing Lan Yun Zhong Zhichao Huang Wei Fan Hui Wang Keli Yang Zhanwen Zhang Huaiming Wang 

机构地区：[1]Department of General Surgery(Colorectal Surgery),The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [2]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [3]Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [4]Department of Nuclear Medicine,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [5]Department of Nuclear Medicine,State Key Laboratory of Oncology in South China,Collaborative Innovation Center of Cancer Medicine,Sun Yat-sen University Cancer Center,Guangzhou,Guangdong,P.R.China

出　　处：《Gastroenterology Report》2024年第1期474-484,共11页胃肠病学报道(英文)

基　　金：the National Natural Science Foundation of China[grant no.82103084];the Dongguan Science and Technology of Social Development Program[grant no.20231800904303];Z.Z.has received grants from the National Natural Science Foundation of China[no.81901772];the Natural Science Foundation of Guangdong Province[nos 2019A1515011893,2023A1515011300];the State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia&The First People’s Hospital of Kashi Fund[no.SKL-HIDCA-2020-KS2];H.W.has received grants from the Xinjiang Autonomous Region Technology Plan[grant no.2022E02125];The Sixth Affiliated Hospital of Sun Yat-Sen University Clinical Research-1010 Program:1010CG(2022)-08;K.Y.has received grants from the National Natural Science Foundation of China[grant no.82300619];the Science and Technology Projects in Guangzhou[grant no.2023A04J2245].

摘　　要：Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor(^(18)F-FAPI-42)and fluorine-18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)for detecting PM of colorectal cancer and to guide clinical decision-making.Methods:Forty-eight patients with PM who underwent both^(18)F-FAPI-42 and^(18)F-FDG PET/CT examinations were studied.The maximum standardized uptake value(SUV max),tumor-to-background ratios(TBRs)and peritoneal cancer index(PCI)of the PM were compared between the two imaging techniques.The intraclass correlation coefficient(ICC)was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI.A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction(complete cytoreduction with no visible disease).Results:The sensitivity and accuracy of^(18)F-FAPI-42 PET/CT for detecting PM were higher than those of^(18)F-FDG PET/CT(82.1%vs 61.1%,P<0.01;84.6%vs 74.5%,P<0.01).The median SUV max and TBR of PM was greater in^(18)F-FAPI-42 than in^(18)F-FDG PET/CT[4.8(1.9-20.1)vs 4.7(1.0-11.0),P=0.02;4.3(1.4-14.6)vs 2.9(0.6-8.0),P<0.01,respectively].The median PCI of PM based on^(18)F-FAPI-42 PET/CT was greater than that based on^(18)F-FDG PET/CT(15 vs 9,P<0.01).The ICC for^(18)F-FAPI-42 PCI was greater than that for^(18)F-FDG PCI(0.915 vs 0.724,P<0.01).The cut-off values of the PCI of the PM for^(18)F-FAPI-42 and^(18)F-FDG PET/CT to predict CC-0 were<18 and<10,with areas under the curve of 0.80 and 0.79,respectively.Conclusions:^(18)F-FAPI-42 PET/CT has superior diagnostic efficacy for PM,particularly in the right upper epigastrium and small intestine.The PCI score of^(18)F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0.The individualized management of

关 键 词：colorectal cancer peritoneal metastasis ^(18)F-FAPI-42 PET/CT PCI 

分 类 号：R73[医药卫生—肿瘤]