^(18)F-FDG PET/CT和^(68)Ga-FAPI PET/CT对不同类型淋巴瘤诊断价值的比较  

Comparison of^(18)F-FDG PET/CT and^(68)Ga-FAPI PET/CT in diagnosis of different types of lymphoma

作　　者：邢泽华 马光 刘菲[1,2,3,4] 张建平 许晓平[1,2,3,4] 胡四龙 宋少莉[1,2,3,4] 刘晓晟 XING Zehua;MA Guang;LIU Fei;ZHANG Jianping;XU Xiaoping;HU Silong;SONG Shaoli;LIU Xiaosheng(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;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]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：《肿瘤影像学》2025年第1期79-85,共7页Oncoradiology

摘　　要：目的:比较^(18)F-氟代脱氧葡萄糖(fluorodeoxyglucose,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^(68)Ga-成纤维细胞活化蛋白抑制剂(fibroblast activation protein inhibitor,FAPI)PET/CT在不同类型淋巴瘤诊断中的价值。方法:回顾并分析2020年11月—2022年10月复旦大学附属肿瘤医院于1周内行^(18)F-FDG和^(68)Ga-FAPI PET/CT的淋巴瘤患者的临床、病理学及影像学资料,比较两种显像剂对病灶的检出率,同时比较两组最大标准摄取值(maximum standard uptake value,SUV_(max))、肿瘤与肌肉本底比值(target-to-background ratio,TBR)及肿瘤与肝脏本底比值(target-to-liver ratio,TLR)的差异。结果:纳入28例经病理学检查确诊的淋巴瘤患者,共计197个淋巴瘤病灶(其中淋巴结病灶167个、结外病灶30个),^(18)F-FDG PET/CT检出191个病灶(其中淋巴结病灶161个、结外病灶30个),而^(68)Ga-FAPI PET/CT检出病灶98个(其中淋巴结病灶74个、结外病灶24个),^(18)F-FDG PET/CT的病灶检出率明显高于^(68)Ga-FAPI PET/CT;但对于胃肠道浸润,^(18)F-FDG PET/CT具有更高的假阳性。所有淋巴瘤患者SUV_(max)-FDG>SUV_(max)-FAPI,TBR-FDG>TBR-FAPI,差异有统计学意义(14.4 vs 6.5,13.3 vs 3.4,P<0.05)。但其中霍奇金淋巴瘤(Hodgkin’s lymphoma,HL)的^(18)F-FDG PET/CT和^(68)Ga-FAPI PET/CT的SUV_(max)及TBR为12.3 vs 6.5及11.6 vs 5.1(均P>0.05);惰性淋巴瘤的SUV_(max)及TBR为10.2 vs 10.9及21.4 vs 5.1(均P>0.05),差异均无统计学意义。所有淋巴瘤患者两种检查的TLR差异均未见明显统计学意义(5.2 vs 5.2,P>0.05)。结论:^(18)F-FDG PET/CT对淋巴瘤的诊断价值优于^(68)Ga-FAPI PET/CT,但是对于HL及惰性淋巴瘤,两者间代谢参数差异无统计学意义,^(18)F-FDG PET/CT的优势不明显;^(68)Ga-FAPI PET/CT对于胃肠道浸润具有更高的诊断准确度。Objective:To compare the value of^(18)F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/computer tomography(CT)and^(68)GA-fibroblast activation protein inhibitor(FAPI)PET/CT in the diagnosis of different types of lymphoma.Methods:The clinical,pathological and imaging data of patients with lymphoma who received^(18)F-FDG and 68Ga-FAPI PET/CT in Fudan University Shanghai Cancer Center within one week from November 2020 to October 2022 were retrospectively analyzed,and the detection rates of the two imaging agents for lesions were compared.At the same time,the differences of maximum standard uptake value(SUV_(max)),target-to-background ratio(TBR)and target-to-liver ratio(TLR)between the two groups were compared.Results:A total of 197 lymphomas(167 lymph node lesions and 30 extranodal lesions)were detected in 28 patients with pathologically confirmed lymphoma,and 191 lesions(161 lymph node lesions and 30 extranodal lesions)were detected by^(18)F-FDG PET/CT.68Ga-FAPI PET/CT detected 98 lesions(including 74 lymph node lesions and 24 extranodal lesions),and the detection rate of^(18)F-FDG PET/CT was significantly higher than that of 68Ga-FAPI PET/CT.But for gastrointestinal infiltrating lesions,^(18)F-FDG PET/CT has a higher false positive rate.In lymphoma patients,SUV_(max)-FDG>SUV_(max)-FAPI,TBR-FDG>TBR-FAPI,the difference was statistically significant(14.4 vs 6.5,13.3 vs 3.4,P<0.05).However,the SUV_(max) and TBR of Hodgkin’s lymphoma(HL)were 12.3 vs 6.5,11.6 vs 5.1(P>0.05)and indolent lymphoma 10.2 vs 10.9,21.4 vs 5.1(P>0.05),the difference was not statistically significant.There was no significant difference in TLR between the two examinations in all lymphoma patients(5.2 vs 5.2,P>0.05).Conclusion:The diagnostic value of^(18)F-FDG PET/CT for lymphoma is better than 68Ga-FAPI PET/CT.But for HL and inert lymphoma,there was no significant difference in metabolic parameters between the two groups,and 68Ga-FAPI PET/CT has higher diagnostic accuracy for gastrointestinal infiltration.

关 键 词：淋巴瘤 正电子发射体层成像/计算机体层成像 氟代脱氧葡萄糖 成纤维细胞活化蛋白抑制剂 

分 类 号：R733.4[医药卫生—肿瘤] R445.5[医药卫生—临床医学]