{"title":"Assessing the Value of <sup>68</sup>Ga-FAPI PET/CT in Gastric Mucinous Adenocarcinoma or Signet Ring Cell Carcinoma.","authors":"Yuyun Sun, Junyan Xu, Ying Qiao, Ji Zhang, Herong Pan, Xiaoping Xu, Shaoli Song","doi":"10.1148/rycan.230195","DOIUrl":null,"url":null,"abstract":"<p><p>Purpose To investigate the clinical impact and prognostic value of gallium 68 (<sup>68</sup>Ga)-labeled fibroblast activation protein inhibitor (FAPI) PET/CT in gastric mucinous adenocarcinoma (MAC) and signet ring cell carcinoma (SRCC). Materials and Methods Eighty-six participants with newly diagnosed or recurrent gastric MAC or SRCC were prospectively enrolled from April 2021 to October 2021 and underwent both fluorine 18 (<sup>18</sup>F) fluorodeoxyglucose (FDG) PET/CT and <sup>68</sup>Ga-FAPI PET/CT. The sensitivity, specificity, and accuracy of the two scans in primary and metastatic tumors were evaluated using the McNemar test. Changes of treatment strategies were recorded to compare the treatment management value of the two PET/CT scans. The maximum standardized uptake value (SUV<sub>max</sub>) and peritoneal cancer index (PCI) were recorded for survival analysis. Progression-free survival (PFS) was defined as the time interval from the date of PET/CT scans to the date of disease progression. Results Eighty-six participants (median age, 62 years [IQR, 45-78 years]; 49 female) were evaluated. <sup>68</sup>Ga-FAPI PET/CT showed higher diagnostic accuracy in detecting involved lymph nodes (87% [212 of 244] vs 71% [173 of 244], <i>P</i> < .001) and peritoneal metastases (96% [70 of 73] vs 55% [40 of 73], <i>P</i> < .001) than <sup>18</sup>F-FDG PET/CT. Twenty-six participants (30% [26 of 86]) had treatment changes due to more accurate diagnosis with <sup>68</sup>Ga-FAPI PET/CT. Additionally, the <sup>68</sup>Ga-FAPI PCI was an independent predictor for PFS (hazard ratio, 6.9; 95% CI: 2.1, 23.1; <i>P</i> = .002). Conclusion <sup>68</sup>Ga-FAPI PET/CT had higher accuracy in diagnosis of gastric MAC/SRCC compared with <sup>18</sup>F-FDG PET/CT and demonstrated the potential to improve treatment strategies and predict prognosis. <b>Keywords:</b> PET/CT, Mucinous Adenocarcinoma, Signet Ring Cell Carcinoma, Oncology, Abdomen/GI, Molecular Imaging <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology. Imaging cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/rycan.230195","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose To investigate the clinical impact and prognostic value of gallium 68 (68Ga)-labeled fibroblast activation protein inhibitor (FAPI) PET/CT in gastric mucinous adenocarcinoma (MAC) and signet ring cell carcinoma (SRCC). Materials and Methods Eighty-six participants with newly diagnosed or recurrent gastric MAC or SRCC were prospectively enrolled from April 2021 to October 2021 and underwent both fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT and 68Ga-FAPI PET/CT. The sensitivity, specificity, and accuracy of the two scans in primary and metastatic tumors were evaluated using the McNemar test. Changes of treatment strategies were recorded to compare the treatment management value of the two PET/CT scans. The maximum standardized uptake value (SUVmax) and peritoneal cancer index (PCI) were recorded for survival analysis. Progression-free survival (PFS) was defined as the time interval from the date of PET/CT scans to the date of disease progression. Results Eighty-six participants (median age, 62 years [IQR, 45-78 years]; 49 female) were evaluated. 68Ga-FAPI PET/CT showed higher diagnostic accuracy in detecting involved lymph nodes (87% [212 of 244] vs 71% [173 of 244], P < .001) and peritoneal metastases (96% [70 of 73] vs 55% [40 of 73], P < .001) than 18F-FDG PET/CT. Twenty-six participants (30% [26 of 86]) had treatment changes due to more accurate diagnosis with 68Ga-FAPI PET/CT. Additionally, the 68Ga-FAPI PCI was an independent predictor for PFS (hazard ratio, 6.9; 95% CI: 2.1, 23.1; P = .002). Conclusion 68Ga-FAPI PET/CT had higher accuracy in diagnosis of gastric MAC/SRCC compared with 18F-FDG PET/CT and demonstrated the potential to improve treatment strategies and predict prognosis. Keywords: PET/CT, Mucinous Adenocarcinoma, Signet Ring Cell Carcinoma, Oncology, Abdomen/GI, Molecular Imaging Supplemental material is available for this article. © RSNA, 2024.
评估 68Ga-FAPI PET/CT 在胃黏液腺癌或信号环细胞癌中的价值
目的 探讨镓68(68Ga)标记的成纤维细胞活化蛋白抑制剂(FAPI)PET/CT对胃粘液腺癌(MAC)和印戒细胞癌(SRCC)的临床影响和预后价值。材料与方法 2021年4月至2021年10月,86名新诊断或复发的胃MAC或SRCC患者接受了氟18(18F)脱氧葡萄糖(FDG)PET/CT和68Ga-FAPI PET/CT检查。使用 McNemar 检验评估了两种扫描对原发性和转移性肿瘤的敏感性、特异性和准确性。记录治疗策略的变化,以比较两种 PET/CT 扫描的治疗管理价值。记录最大标准化摄取值(SUVmax)和腹膜癌指数(PCI)用于生存分析。无进展生存期(PFS)的定义是从 PET/CT 扫描日期到疾病进展日期的时间间隔。结果 共评估了 86 名参与者(中位年龄 62 岁 [IQR,45-78 岁];49 名女性)。68Ga-FAPI PET/CT 在检测受累淋巴结(87% [244 例中的 212 例] vs 71% [244 例中的 173 例],P < .001)和腹膜转移(96% [73 例中的 70 例] vs 55% [73 例中的 40 例],P < .001)方面的诊断准确率高于 18F-FDG PET/CT。由于 68Ga-FAPI PET/CT 诊断更准确,26 名参与者(30% [86 人中的 26 人])改变了治疗方法。此外,68Ga-FAPI PCI 是预测 PFS 的独立指标(危险比为 6.9;95% CI:2.1, 23.1;P = .002)。结论 与18F-FDG PET/CT相比,68Ga-FAPI PET/CT在诊断胃MAC/SRCC方面具有更高的准确性,并显示出改善治疗策略和预测预后的潜力。关键词PET/CT,黏液腺癌,信号环细胞癌,肿瘤学,腹部/消化道,分子影像学 本文有补充材料。© RSNA, 2024.
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