Xuetao Chen, Shuailiang Wang, Yumei Lai, Guochang Wang, Maomao Wei, Xiao Jin, Jin Ding, Yan Zhang, Yunfei Shi, Feng Wang, Hua Zhu, Zhi Yang, Xuejuan Wang
{"title":"淋巴瘤诊断中的成纤维细胞活化蛋白和糖酵解：68Ga-FAPI PET/CT 与 18F-FDG PET/CT 的比较。","authors":"Xuetao Chen, Shuailiang Wang, Yumei Lai, Guochang Wang, Maomao Wei, Xiao Jin, Jin Ding, Yan Zhang, Yunfei Shi, Feng Wang, Hua Zhu, Zhi Yang, Xuejuan Wang","doi":"10.2967/jnumed.123.265530","DOIUrl":null,"url":null,"abstract":"<p><p>Our objective was to compare the diagnostic performance of <sup>68</sup>Ga-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and <sup>18</sup>F-labeled FDG PET/CT in diagnosing lymphomas and to characterize the influence of FAP and glycolytic markers on tracer uptake by involved lesions. <b>Methods:</b> Participants with different lymphoma subtypes who were prospectively recruited from May 2020 to December 2021 underwent <sup>68</sup>Ga-FAPI and <sup>18</sup>F-FDG PET/CT. Immunohistochemistry was performed to evaluate FAP, hexokinase 2, and glucose transporter 1 (GLUT1) expression, and the paired-samples <i>t</i> test and Wilcoxon signed-rank test were used to compare parameters. The correlation between the immunochemistry results and tracer uptake was determined by the Spearman rank correlation coefficient. <b>Results:</b> In total, 186 participants (median age, 52 y [interquartile range, 41-64 y]; 95 women) were included. Dual-tracer imaging produced 3 types of imaging profiles. <sup>18</sup>F-FDG PET possessed a higher staging accuracy (98.4%) than <sup>68</sup>Ga-FAPI PET (86.0%). In 5,980 lymphoma lesions, <sup>18</sup>F-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than <sup>68</sup>Ga-FAPI PET/CT. Additionally, 52 <sup>68</sup>Ga-FAPI-positive/<sup>18</sup>F-FDG-negative lesions and 2,939 <sup>68</sup>Ga-FAPI-negative/<sup>18</sup>F-FDG-positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUV<sub>max</sub> or target-to-liver ratios between <sup>68</sup>Ga-FAPI and <sup>18</sup>F-FDG PET/CT (<i>P</i> > 0.05). Interestingly, GLUT1 and hexokinase 2 were overexpressed both in lymphoma cells and in the tumor microenvironment, whereas FAP was expressed only in stromal cells. FAP and GLUT1 expression correlated positively with <sup>68</sup>Ga-FAPI SUV<sub>max</sub> (<i>r</i> = 0.622, <i>P</i> = 0.001) and <sup>18</sup>F-FDG SUV<sub>max</sub> (<i>r</i> = 0.835, <i>P</i> < 0.001), respectively. <b>Conclusion:</b> <sup>68</sup>Ga-FAPI PET/CT was inferior to <sup>18</sup>F-FDG PET/CT in diagnosing lymphomas with low FAP expression. However, the former may supplement the latter and help reveal the molecular profile of lymphomas.</p>","PeriodicalId":16758,"journal":{"name":"Journal of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":9.1000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fibroblast Activation Protein and Glycolysis in Lymphoma Diagnosis: Comparison of <sup>68</sup>Ga-FAPI PET/CT and <sup>18</sup>F-FDG PET/CT.\",\"authors\":\"Xuetao Chen, Shuailiang Wang, Yumei Lai, Guochang Wang, Maomao Wei, Xiao Jin, Jin Ding, Yan Zhang, Yunfei Shi, Feng Wang, Hua Zhu, Zhi Yang, Xuejuan Wang\",\"doi\":\"10.2967/jnumed.123.265530\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Our objective was to compare the diagnostic performance of <sup>68</sup>Ga-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and <sup>18</sup>F-labeled FDG PET/CT in diagnosing lymphomas and to characterize the influence of FAP and glycolytic markers on tracer uptake by involved lesions. <b>Methods:</b> Participants with different lymphoma subtypes who were prospectively recruited from May 2020 to December 2021 underwent <sup>68</sup>Ga-FAPI and <sup>18</sup>F-FDG PET/CT. Immunohistochemistry was performed to evaluate FAP, hexokinase 2, and glucose transporter 1 (GLUT1) expression, and the paired-samples <i>t</i> test and Wilcoxon signed-rank test were used to compare parameters. The correlation between the immunochemistry results and tracer uptake was determined by the Spearman rank correlation coefficient. <b>Results:</b> In total, 186 participants (median age, 52 y [interquartile range, 41-64 y]; 95 women) were included. Dual-tracer imaging produced 3 types of imaging profiles. <sup>18</sup>F-FDG PET possessed a higher staging accuracy (98.4%) than <sup>68</sup>Ga-FAPI PET (86.0%). In 5,980 lymphoma lesions, <sup>18</sup>F-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than <sup>68</sup>Ga-FAPI PET/CT. Additionally, 52 <sup>68</sup>Ga-FAPI-positive/<sup>18</sup>F-FDG-negative lesions and 2,939 <sup>68</sup>Ga-FAPI-negative/<sup>18</sup>F-FDG-positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUV<sub>max</sub> or target-to-liver ratios between <sup>68</sup>Ga-FAPI and <sup>18</sup>F-FDG PET/CT (<i>P</i> > 0.05). Interestingly, GLUT1 and hexokinase 2 were overexpressed both in lymphoma cells and in the tumor microenvironment, whereas FAP was expressed only in stromal cells. FAP and GLUT1 expression correlated positively with <sup>68</sup>Ga-FAPI SUV<sub>max</sub> (<i>r</i> = 0.622, <i>P</i> = 0.001) and <sup>18</sup>F-FDG SUV<sub>max</sub> (<i>r</i> = 0.835, <i>P</i> < 0.001), respectively. <b>Conclusion:</b> <sup>68</sup>Ga-FAPI PET/CT was inferior to <sup>18</sup>F-FDG PET/CT in diagnosing lymphomas with low FAP expression. However, the former may supplement the latter and help reveal the molecular profile of lymphomas.</p>\",\"PeriodicalId\":16758,\"journal\":{\"name\":\"Journal of Nuclear Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":9.1000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2967/jnumed.123.265530\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/6/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2967/jnumed.123.265530","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Fibroblast Activation Protein and Glycolysis in Lymphoma Diagnosis: Comparison of 68Ga-FAPI PET/CT and 18F-FDG PET/CT.
Our objective was to compare the diagnostic performance of 68Ga-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and 18F-labeled FDG PET/CT in diagnosing lymphomas and to characterize the influence of FAP and glycolytic markers on tracer uptake by involved lesions. Methods: Participants with different lymphoma subtypes who were prospectively recruited from May 2020 to December 2021 underwent 68Ga-FAPI and 18F-FDG PET/CT. Immunohistochemistry was performed to evaluate FAP, hexokinase 2, and glucose transporter 1 (GLUT1) expression, and the paired-samples t test and Wilcoxon signed-rank test were used to compare parameters. The correlation between the immunochemistry results and tracer uptake was determined by the Spearman rank correlation coefficient. Results: In total, 186 participants (median age, 52 y [interquartile range, 41-64 y]; 95 women) were included. Dual-tracer imaging produced 3 types of imaging profiles. 18F-FDG PET possessed a higher staging accuracy (98.4%) than 68Ga-FAPI PET (86.0%). In 5,980 lymphoma lesions, 18F-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than 68Ga-FAPI PET/CT. Additionally, 52 68Ga-FAPI-positive/18F-FDG-negative lesions and 2,939 68Ga-FAPI-negative/18F-FDG-positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUVmax or target-to-liver ratios between 68Ga-FAPI and 18F-FDG PET/CT (P > 0.05). Interestingly, GLUT1 and hexokinase 2 were overexpressed both in lymphoma cells and in the tumor microenvironment, whereas FAP was expressed only in stromal cells. FAP and GLUT1 expression correlated positively with 68Ga-FAPI SUVmax (r = 0.622, P = 0.001) and 18F-FDG SUVmax (r = 0.835, P < 0.001), respectively. Conclusion:68Ga-FAPI PET/CT was inferior to 18F-FDG PET/CT in diagnosing lymphomas with low FAP expression. However, the former may supplement the latter and help reveal the molecular profile of lymphomas.
期刊介绍：
The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.
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