^(18)F标记成纤维细胞活化蛋白抑制剂PET/CT对^(18)F-FDG摄取偏低恶性肿瘤的临床诊断价值  

Clinical diagnosis value of^(18)F-fibroblast-activation protein inhibitor PET/CT in malignant tumors with low^(18)F-fluorodeoxyglucose uptake

作　　者：梁志盈 林培颖 张汝森 李雯 李伟 Liang Zhi-Ying;Lin Pei-Ying;Zhang Ru-Sen;Li Wen;Li Wei(Department of Nuclear Medicine,Affiliated Cancer Hospital and Institute of Guangzhou Medical University,Guangzhou,Guangdong 510095,China)

机构地区：[1]广州医科大学附属肿瘤医院核医学科,广东广州510095

出　　处：《解放军医学杂志》2025年第2期154-161,共8页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨^(18)F标记的成纤维细胞活化蛋白抑制剂(^(18)F-FAPI)PET/CT对^(18)F-氟代脱氧葡萄糖(^(18)F-FDG)摄取偏低的恶性肿瘤的临床诊断价值。方法前瞻性选取2021年1月-2022年11月在广州医科大学附属肿瘤医院确诊并接受^(18)FFAPI PET/CT检查的62例^(18)F-FDG摄取偏低的恶性肿瘤患者。收集所有患者的一般信息、临床和影像资料。参照肿瘤邻近组织对^(18)F-FDG和^(18)F-FAPI的摄取水平,将肿瘤病灶分为高摄取、中摄取与低摄取,其中高摄取病灶设为阳性。记录并比较^(18)F-FDG与^(18)F-FAPI显示的肿瘤原发灶、转移灶数量及其摄取水平。结果62例原发恶性肿瘤对^(18)F-FDG低摄取18例(29.0%)、中摄取44例(71.0%),而对^(18)F-FAPI低摄取1例(1.6%)、中摄取6例(9.7%)、高摄取55例(88.7%)。原发肿瘤^(18)FFAPI的最大标准摄取值(SUV_(max))明显高于^(18)F-FDG(7.5±5.6 vs.3.9±2.1,P<0.001)。^(18)F-FAPI PET检出的阳性淋巴结数明显多于^(18)F-FDG PET(77个vs.38个,P<0.01)。共检出16个远处转移灶,其中^(18)F-FDG PET/CT检出11个(68.8%),^(18)F-FAPI PET/CT检出15个(93.8%),两种示踪剂的检出率比较差异无统计学意义(P>0.05)。结论对于^(18)F-FDG摄取偏低的恶性肿瘤,^(18)F-FAPI PET/CT可较好地显示肿瘤原发灶和转移灶。^(18)F-FAPI可作为一种较有前景的放射性示踪剂,尤其适用于^(18)F-FDG摄取偏低的恶性肿瘤。Objective To evaluate the clinical value of^(18)F-fibroblast-activation protein inhibitor(^(18)F-FAPI)PET/CT in malignant tumors exhibiting low uptake of^(18)F-fluorodeoxyglucose(^(18)F-FDG).Methods We prospectively analyzed 62 patients with malignant tumors and low^(18)F-FDG uptake who underwent^(18)F-FAPI PET/CT in the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from January 2021 to November 2022.Patient demographics information,clinical and radiological data were collected.Tumor lesions were categorized based on^(18)F-FAPI and^(18)F-FDG uptake relative to surrounding tissues into low-,moderate-,and high-uptake,with high uptake indicating positivity.The number and tracer uptake levels of primary tumors and metastatic lesions visualized by both^(18)F-FDG and^(18)F-FAPI were recorded and compared.Results Of the 62 primary tumors,18(29.0%)showed low-uptake and 44(71.0%)moderate-uptake on^(18)F-FDG PET,while 1(1.6%),6(9.7%),and 55(88.7%)showed low,moderate,and high uptake on^(18)F-FAPI,respectively.The maximum standardized uptake value(SUVmax)for primary tumors was significantly higher with^(18)F-FAPI than with^(18)F-FDG(7.5±5.6 vs.3.9±2.1,P<0.01).The number of positive lymph node foci revealed by^(18)F-FAPI was noticeably higher than that by^(18)F-FDG(77 vs.38,P<0.01).A total of 16 distant organ metastases were identified,with 11(68.8%)detected by^(18)F-FDG and 15(93.8%)by^(18)F-FAPI,showing no significant difference in detection rates(P>0.05).Conclusions^(18)F-FAPI PET/CT effectively visualizes primary and metastatic lesions in malignant tumors with low^(18)F-FDG uptake,suggesting its potential as a promising radiotracer for such malignancies.

关 键 词：^(18)F标记的成纤维细胞活化蛋白抑制剂 ^(18)F-氟代脱氧葡萄糖 PET/CT 肿瘤 低摄取 

分 类 号：R730.44[医药卫生—肿瘤]