Masao Watanabe, Wolfgang P Fendler, Hong Grafe, Nader Hirmas, Rainer Hamacher, Helena Lanzafame, Kim M Pabst, Hubertus Hautzel, Clemens Aigner, Stefan Kasper, Bastian von Tresckow, Martin Stuschke, Sherko Kümmel, Celine Lugnier, Boris Hadaschik, Viktor Grünwald, Fadi Zarrad, David Kersting, Jens T Siveke, Ken Herrmann, Manuel Weber
{"title":"68 Ga-FAPI-46 PET/CT、18F-FDG PET/CT 和对比增强 CT 在检测各种肿瘤方面的头对头比较。","authors":"Masao Watanabe, Wolfgang P Fendler, Hong Grafe, Nader Hirmas, Rainer Hamacher, Helena Lanzafame, Kim M Pabst, Hubertus Hautzel, Clemens Aigner, Stefan Kasper, Bastian von Tresckow, Martin Stuschke, Sherko Kümmel, Celine Lugnier, Boris Hadaschik, Viktor Grünwald, Fadi Zarrad, David Kersting, Jens T Siveke, Ken Herrmann, Manuel Weber","doi":"10.1007/s12149-024-01993-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of <sup>68</sup> Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), <sup>18</sup>F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.</p><p><strong>Methods: </strong>232 patients underwent <sup>68</sup> Ga-FAPI-46 PET/CT,<sup>18</sup>F-FDG PET/CT, and CE-CT each within 4 weeks. Detection rates were assessed by a blinded reader, with ≥ 2 weeks between scans of the same patient to avoid recall bias. A sub-analysis of diagnostic performance was performed for 490 histopathologically validated lesions. Detection rates were compared using McNemar's test.</p><p><strong>Results: </strong>Lesion-based detection rates in <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT, <sup>18</sup>F-FDG PET/CT plus CE-CT, and CE-CT alone were 91.2% (1540/1688), 82.5% (1393/1688) and 60.2% (1016/1688). The detection rates were significantly higher for <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT than for <sup>18</sup>F-FDG PET/CT plus CE-CT (p < 0.02 for primary lesions and p < 0.001 for total, abdominopelvic nodal, liver and other visceral lesions) and CE-CT (p < 0.0001 for total, primary, cervicothoracic nodal, abdominopelvic nodal, liver, other visceral, and bone lesions). In the sub-analysis, sensitivity, specificity, positive and negative predictive value, and accuracy were 61.3%, 96.7%, 81.4%, 91.4% and 90.0% for <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT, 57.0%, 95.7%, 75.7%, 90.5% and 88.4% for <sup>18</sup>F-FDG PET/CT plus CE-CT, and 51.6%, 97.2%, 81.4%, 89.6% and 88.6% for CECT, respectively.</p><p><strong>Conclusions: </strong><sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT demonstrates a higher tumor detection rate than <sup>18</sup>F-FDG PET/CT plus CE-CT and CE-CT in a diverse spectrum of malignancies, especially for primary, abdominopelvic nodal, liver, and other visceral lesions. Further studies on which entities draw particular benefit from <sup>68</sup> Ga-FAPI-46 PET/CT are warranted to aid appropriate diagnostic workup.</p><p><strong>Trial registration: </strong>A total of N = 232 patients were analyzed. Of these, N = 50 patients were included in a prospective interventional trial (NCT05160051), and N = 175 in a prospective observational trial (NCT04571086) for correlation and clinical follow-up of PET findings; N = 7 patients were analyzed retrospectively.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Head-to-head comparison of <sup>68</sup> Ga-FAPI-46 PET/CT, <sup>18</sup>F-FDG PET/CT, and contrast-enhanced CT for the detection of various tumors.\",\"authors\":\"Masao Watanabe, Wolfgang P Fendler, Hong Grafe, Nader Hirmas, Rainer Hamacher, Helena Lanzafame, Kim M Pabst, Hubertus Hautzel, Clemens Aigner, Stefan Kasper, Bastian von Tresckow, Martin Stuschke, Sherko Kümmel, Celine Lugnier, Boris Hadaschik, Viktor Grünwald, Fadi Zarrad, David Kersting, Jens T Siveke, Ken Herrmann, Manuel Weber\",\"doi\":\"10.1007/s12149-024-01993-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of <sup>68</sup> Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), <sup>18</sup>F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.</p><p><strong>Methods: </strong>232 patients underwent <sup>68</sup> Ga-FAPI-46 PET/CT,<sup>18</sup>F-FDG PET/CT, and CE-CT each within 4 weeks. Detection rates were assessed by a blinded reader, with ≥ 2 weeks between scans of the same patient to avoid recall bias. A sub-analysis of diagnostic performance was performed for 490 histopathologically validated lesions. Detection rates were compared using McNemar's test.</p><p><strong>Results: </strong>Lesion-based detection rates in <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT, <sup>18</sup>F-FDG PET/CT plus CE-CT, and CE-CT alone were 91.2% (1540/1688), 82.5% (1393/1688) and 60.2% (1016/1688). The detection rates were significantly higher for <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT than for <sup>18</sup>F-FDG PET/CT plus CE-CT (p < 0.02 for primary lesions and p < 0.001 for total, abdominopelvic nodal, liver and other visceral lesions) and CE-CT (p < 0.0001 for total, primary, cervicothoracic nodal, abdominopelvic nodal, liver, other visceral, and bone lesions). In the sub-analysis, sensitivity, specificity, positive and negative predictive value, and accuracy were 61.3%, 96.7%, 81.4%, 91.4% and 90.0% for <sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT, 57.0%, 95.7%, 75.7%, 90.5% and 88.4% for <sup>18</sup>F-FDG PET/CT plus CE-CT, and 51.6%, 97.2%, 81.4%, 89.6% and 88.6% for CECT, respectively.</p><p><strong>Conclusions: </strong><sup>68</sup> Ga-FAPI-46 PET/CT plus CE-CT demonstrates a higher tumor detection rate than <sup>18</sup>F-FDG PET/CT plus CE-CT and CE-CT in a diverse spectrum of malignancies, especially for primary, abdominopelvic nodal, liver, and other visceral lesions. Further studies on which entities draw particular benefit from <sup>68</sup> Ga-FAPI-46 PET/CT are warranted to aid appropriate diagnostic workup.</p><p><strong>Trial registration: </strong>A total of N = 232 patients were analyzed. Of these, N = 50 patients were included in a prospective interventional trial (NCT05160051), and N = 175 in a prospective observational trial (NCT04571086) for correlation and clinical follow-up of PET findings; N = 7 patients were analyzed retrospectively.</p>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12149-024-01993-7\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12149-024-01993-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Head-to-head comparison of 68 Ga-FAPI-46 PET/CT, 18F-FDG PET/CT, and contrast-enhanced CT for the detection of various tumors.
Objective: FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of 68 Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), 18F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.
Methods: 232 patients underwent 68 Ga-FAPI-46 PET/CT,18F-FDG PET/CT, and CE-CT each within 4 weeks. Detection rates were assessed by a blinded reader, with ≥ 2 weeks between scans of the same patient to avoid recall bias. A sub-analysis of diagnostic performance was performed for 490 histopathologically validated lesions. Detection rates were compared using McNemar's test.
Results: Lesion-based detection rates in 68 Ga-FAPI-46 PET/CT plus CE-CT, 18F-FDG PET/CT plus CE-CT, and CE-CT alone were 91.2% (1540/1688), 82.5% (1393/1688) and 60.2% (1016/1688). The detection rates were significantly higher for 68 Ga-FAPI-46 PET/CT plus CE-CT than for 18F-FDG PET/CT plus CE-CT (p < 0.02 for primary lesions and p < 0.001 for total, abdominopelvic nodal, liver and other visceral lesions) and CE-CT (p < 0.0001 for total, primary, cervicothoracic nodal, abdominopelvic nodal, liver, other visceral, and bone lesions). In the sub-analysis, sensitivity, specificity, positive and negative predictive value, and accuracy were 61.3%, 96.7%, 81.4%, 91.4% and 90.0% for 68 Ga-FAPI-46 PET/CT plus CE-CT, 57.0%, 95.7%, 75.7%, 90.5% and 88.4% for 18F-FDG PET/CT plus CE-CT, and 51.6%, 97.2%, 81.4%, 89.6% and 88.6% for CECT, respectively.
Conclusions: 68 Ga-FAPI-46 PET/CT plus CE-CT demonstrates a higher tumor detection rate than 18F-FDG PET/CT plus CE-CT and CE-CT in a diverse spectrum of malignancies, especially for primary, abdominopelvic nodal, liver, and other visceral lesions. Further studies on which entities draw particular benefit from 68 Ga-FAPI-46 PET/CT are warranted to aid appropriate diagnostic workup.
Trial registration: A total of N = 232 patients were analyzed. Of these, N = 50 patients were included in a prospective interventional trial (NCT05160051), and N = 175 in a prospective observational trial (NCT04571086) for correlation and clinical follow-up of PET findings; N = 7 patients were analyzed retrospectively.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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