{"title":"18F-FAPI-42 PET/CT 提高结直肠癌腹膜转移的诊断效果并指导治疗决策：一项原创性回顾研究。","authors":"Xuneng Zhang, Rongqin Zhang, Qingyang Zheng, Zichuan He, Bing Lan, Yun Zhong, Zhichao Huang, Wei Fan, Hui Wang, Keli Yang, Zhanwen Zhang, Huaiming Wang","doi":"10.1093/gastro/goae104","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (<sup>18</sup>F-FAPI-42) and fluorine-18 fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.</p><p><strong>Methods: </strong>Forty-eight patients with PM who underwent both <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).</p><p><strong>Results: </strong>The sensitivity and accuracy of <sup>18</sup>F-FAPI-42 PET/CT for detecting PM were higher than those of <sup>18</sup>F-FDG PET/CT (82.1% vs 61.1%, <i>P </i><<i> </i>0.01; 84.6% vs 74.5%, <i>P </i><<i> </i>0.01). The median SUV max and TBR of PM was greater in <sup>18</sup>F-FAPI-42 than in <sup>18</sup>F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), <i>P </i>=<i> </i>0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), <i>P </i><<i> </i>0.01, respectively]. The median PCI of PM based on <sup>18</sup>F-FAPI-42 PET/CT was greater than that based on <sup>18</sup>F-FDG PET/CT (15 vs 9, <i>P </i><<i> </i>0.01). The ICC for <sup>18</sup>F-FAPI-42 PCI was greater than that for <sup>18</sup>F-FDG PCI (0.915 vs 0.724, <i>P </i><<i> </i>0.01). The cut-off values of the PCI of the PM for <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.</p><p><strong>Conclusions: </strong><sup>18</sup>F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of <sup>18</sup>F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the <sup>18</sup>F-FAPI-42 PET/CT PCI score is pivotal.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae104"},"PeriodicalIF":3.8000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646066/pdf/","citationCount":"0","resultStr":"{\"title\":\"<sup>18</sup>F-FAPI-42 PET/CT enhances the diagnostic efficacy for peritoneal metastasis of colorectal cancer and guides treatment decisions: an original retrospective study.\",\"authors\":\"Xuneng Zhang, Rongqin Zhang, Qingyang Zheng, Zichuan He, Bing Lan, Yun Zhong, Zhichao Huang, Wei Fan, Hui Wang, Keli Yang, Zhanwen Zhang, Huaiming Wang\",\"doi\":\"10.1093/gastro/goae104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (<sup>18</sup>F-FAPI-42) and fluorine-18 fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.</p><p><strong>Methods: </strong>Forty-eight patients with PM who underwent both <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).</p><p><strong>Results: </strong>The sensitivity and accuracy of <sup>18</sup>F-FAPI-42 PET/CT for detecting PM were higher than those of <sup>18</sup>F-FDG PET/CT (82.1% vs 61.1%, <i>P </i><<i> </i>0.01; 84.6% vs 74.5%, <i>P </i><<i> </i>0.01). The median SUV max and TBR of PM was greater in <sup>18</sup>F-FAPI-42 than in <sup>18</sup>F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), <i>P </i>=<i> </i>0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), <i>P </i><<i> </i>0.01, respectively]. The median PCI of PM based on <sup>18</sup>F-FAPI-42 PET/CT was greater than that based on <sup>18</sup>F-FDG PET/CT (15 vs 9, <i>P </i><<i> </i>0.01). The ICC for <sup>18</sup>F-FAPI-42 PCI was greater than that for <sup>18</sup>F-FDG PCI (0.915 vs 0.724, <i>P </i><<i> </i>0.01). The cut-off values of the PCI of the PM for <sup>18</sup>F-FAPI-42 and <sup>18</sup>F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.</p><p><strong>Conclusions: </strong><sup>18</sup>F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of <sup>18</sup>F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the <sup>18</sup>F-FAPI-42 PET/CT PCI score is pivotal.</p>\",\"PeriodicalId\":54275,\"journal\":{\"name\":\"Gastroenterology Report\",\"volume\":\"12 \",\"pages\":\"goae104\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646066/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Report\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/gastro/goae104\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Report","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/gastro/goae104","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：结直肠癌是第三常见的癌症类型。当发生腹膜转移（PM）时，诊断转移灶是困难的，预后很差。本研究旨在比较氟-18成纤维细胞活化蛋白特异性抑制剂（18F-FAPI-42）与氟-18氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）对大肠癌PM的检测价值，指导临床决策。方法：对48例同时行18F-FAPI-42和18F-FDG PET/CT检查的PM患者进行研究。比较两种成像技术PM的最大标准化摄取值（SUV max）、肿瘤与背景比（TBRs）和腹膜癌指数（PCI）。采用类内相关系数（intraclass correlation coefficient， ICC）比较PET/CT PCI评分与术中PCI的一致性。采用受体工作特征曲线预测CC-0细胞减少的准确性（细胞完全减少，无明显疾病）。结果：18F-FAPI-42 PET/CT检测PM的灵敏度和准确度均高于18F-FDG PET/CT (82.1% vs 61.1%, P 0.01；84.6% vs 74.5%, P < 0.01)。18F-FAPI-42组PM的中位SUV max和TBR均大于18F-FDG PET/CT组[4.8 (1.9-20.1)vs 4.7 (1.0-11.0), P = 0.02；4.3(1.4 - -14.6)和2.9(0.6 - -8.0),分别为P 0.01)。基于18F-FAPI-42 PET/CT的PM PCI中位值高于基于18F-FDG PET/CT的PM PCI中位值（15 vs 9, P 0.01）。18F-FAPI-42 PCI的ICC大于18F-FDG PCI （0.915 vs 0.724, P 0.01）。18F-FAPI-42和18F-FDG PET/CT对PM的PCI截断值预测CC-0为结论：18F-FAPI-42 PET/CT对PM的诊断效果较好，尤其是对右上腹部和小肠。18F-FAPI-42 PET/CT PCI评分与术中PCI评分非常接近，对预测CC-0有很高的价值。基于18F-FAPI-42 PET/CT PCI评分的PM个性化管理是关键。
18F-FAPI-42 PET/CT enhances the diagnostic efficacy for peritoneal metastasis of colorectal cancer and guides treatment decisions: an original retrospective study.
Background: Colorectal cancer is the third-most common type of cancer. When peritoneal metastasis (PM) develops, diagnosing metastatic lesions is difficult and the prognosis is poor. This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor (18F-FAPI-42) and fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting PM of colorectal cancer and to guide clinical decision-making.
Methods: Forty-eight patients with PM who underwent both 18F-FAPI-42 and 18F-FDG PET/CT examinations were studied. The maximum standardized uptake value (SUV max), tumor-to-background ratios (TBRs) and peritoneal cancer index (PCI) of the PM were compared between the two imaging techniques. The intraclass correlation coefficient (ICC) was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI. A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction (complete cytoreduction with no visible disease).
Results: The sensitivity and accuracy of 18F-FAPI-42 PET/CT for detecting PM were higher than those of 18F-FDG PET/CT (82.1% vs 61.1%, P <0.01; 84.6% vs 74.5%, P <0.01). The median SUV max and TBR of PM was greater in 18F-FAPI-42 than in 18F-FDG PET/CT [4.8 (1.9-20.1) vs 4.7 (1.0-11.0), P =0.02; 4.3 (1.4-14.6) vs 2.9 (0.6-8.0), P <0.01, respectively]. The median PCI of PM based on 18F-FAPI-42 PET/CT was greater than that based on 18F-FDG PET/CT (15 vs 9, P <0.01). The ICC for 18F-FAPI-42 PCI was greater than that for 18F-FDG PCI (0.915 vs 0.724, P <0.01). The cut-off values of the PCI of the PM for 18F-FAPI-42 and 18F-FDG PET/CT to predict CC-0 were <18 and <10, with areas under the curve of 0.80 and 0.79, respectively.
Conclusions: 18F-FAPI-42 PET/CT has superior diagnostic efficacy for PM, particularly in the right upper epigastrium and small intestine. The PCI score of 18F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0. The individualized management of PM based on the 18F-FAPI-42 PET/CT PCI score is pivotal.
期刊介绍：
Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.
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