|本期目录/Table of Contents|

68Ga-FAPI-04 PET/CT在胰腺癌与胰腺炎鉴别诊断中的价值

《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:
2022年23期
页码:
4344-4348
栏目:
论著(肿瘤影像及介入)
出版日期:
2022-10-28

文章信息/Info

Title:
Application of 68Ga-FAPI-04 PET/CT in differential diagnosis of pancreatic cancer and pancreatitis
作者:
王安波12何丽萌3邓 颖3李红梅1张 伟13
1.西南医科大学附属医院核医学科,四川 泸州 646000; 2.内江市第一人民医院核医学科,四川 内江 641000; 3.四川省医学科学院/四川省人民医院,四川 成都 610072
Author(s):
WANG Anbo12HE Limeng3DENG Ying3LI Hongmei1ZHANG Wei13
1.Department of Nuclear Medicine,the Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China;2.Nuclear Medicine Discipline of Neijiang First People's Hospital,Sichuan Neijiang 641000,China;3.Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital,Sichuan Chengdu 610072,China.
关键词:
成纤维细胞活化蛋白抑制剂胰腺成纤维细胞活化蛋白正电子发射断层扫描/计算机断层扫描
Keywords:
FAPIpancreasFAPgalliumPET/CT
分类号:
A
DOI:
10.3969/j.issn.1672-4992.2022.23.025
文献标识码:
R735.9
摘要:
目的:探讨68Ga-FAPI-04 PET/CT在胰腺癌与胰腺炎鉴别诊断中的应用价值。方法:回顾性分析西南医科大学附属医院核医学科2020年09月至2021年03月61例68Ga-FAPI-04 PET/CT胰腺摄取阳性患者的影像学资料,并根据术后病理、病史、血淀粉酶、血清肿瘤标志物、彩超及MRI检查、随访结果等将病例分为胰腺癌组(16例),急性胰腺炎组(12例),慢性胰腺炎组(11例)及非特异性摄取组(22例),并对这四组病例进行分析。结果:四组间SUVmax值比较,差异有统计学意义(P<0.05);Post hoc分别比较,急性胰腺炎组与胰腺癌组的SUVmax值均显著大于慢性胰腺炎组及非特异性摄取组;慢性胰腺炎组SUVmax值大于非特异性摄取组,差异有统计学意义(P<0.05);当尤登指数为0.773时,SUVmax分界值为6.45,此时68Ga-FAPI-04 PET/CT对应的灵敏度为90.9%,特异度为86.4%,准确性为87.9%,阳性预测值76.9%,阴性预测值95.0%;急性胰腺炎组与胰腺癌组的SUVmax值差异没有统计学意义,但通过摄取示踪剂的形态及同机CT表现可进行鉴别;胰腺癌肿块大小与SUVmax值呈正相关关系。结论:68Ga-FAPI-04作为一种新的示踪剂,通过PET/CT显像在胰腺疾病的诊断上有很大的潜力,在鉴别胰腺病灶良恶性方面有重要价值。
Abstract:
Objective:To explore the value of 68Ga-FAPI-04 PET/CT in differential diagnosis of pancreatic cancer and pancreatitis. Methods:The imaging data of 61 patients with 68Ga-FAPI-04 PET/CT positive pancreatic uptake from September 2020 to March 2021 in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed.According to postoperative pathology,medical history,serum amylase,serum tumor markers,color Doppler ultrasound and MRI examination,and follow-up results,the patients were divided into pancreatic cancer group(16 cases) and acute pancreatitis group(12 cases).Chronic pancreatitis group(11 cases) and nonspecific uptake group(22 cases),and the four groups of cases were analyzed.Results:There was significant difference in SUVmax between the four groups(P<0.05).Compared with Post hoc,the SUVmax values of acute pancreatitis group and pancreatic cancer group were significantly higher than those of chronic pancreatitis group and non-specific uptake group.SUVmax in chronic pancreatitis group was higher than that in nonspecific intake group(P<0.05).When the Youden index was 0.773,the SUVmax boundary value was 6.45.At this time,the corresponding sensitivity of 68Ga-FAPI-04 PET/CT was 90.9%,the specificity was 86.4%,the accuracy was 87.9%,the positive predictive value was 76.9%,and the negative predictive value was 95.0%.The difference of SUVmax between acute pancreatitis group and pancreatic cancer group was not statistically significant,but it could be identified by taking the form of tracer and CT.The size of pancreatic cancer was positively correlated with the SUVmax value.Conclusion:As a new tracer,68Ga-FAPI-04 PET/CT has great potential in the diagnosis of pancreatic diseases through PET/CT imaging,and has important value in differentiating benign and malignant pancreatic lesions.

参考文献/References

[1]SIEGEL RL,MILLER KD,JEMAL A.Cancer statistics,2019[J].CA Cancer J Clin,2019,69(1):7-34.
[2]GIESEL FL,KRATOCHWIL C,LINDNER T,et al.68Ga-FAPI PET/CT:Biodistribution and preliminary dosimetry estimate of 2 DOTA-containing FAP-targeting agents in patients with various cancers[J].J Nucl Med,2019,60(3):386-392.
[3]HAMSON EJ,KEANE FM,THOLEN S,et al.Understanding fibroblast activation protein(FAP):substrates,activities,expression and targeting for cancer therapy[J].Proteomics Clin Appl,2014,8(5-6):454-463.
[4]LIAO Z,TAN ZW,ZHU P,et al.Cancer-associated fibroblasts in tumor microenvironment-Accomplices in tumor malignancy[J].Cell Immunol,2019,343:103729.
[5]SANTI A,KUGERATSKI FG,ZANIVAN S.Cancer associated fibroblasts:The architects of stroma remodeling[J].Proteomics,2018,18(5-6):e1700167.
[6]KALLURI R.The biology and function of fibroblasts in cancer[J].Nat Rev Cancer,2016,16(9):582-598.
[7]MCCARTHY JB,EL-ASHRY D,TURLEY EA.Hyaluronan,cancer-associated fibroblasts and the tumor microenvironment in malignant progression[J].Front Cell Dev Biol,2018,6:48.
[8]WANG Z,TANG Y,TAN Y,et al.Cancer-associated fibroblasts in radiotherapy:challenges and new opportunities[J].Cell Commun Signal,2019,17(1):47.
[9]LINDNER T,LOKTEV A,ALTMANN A,et al.Development of quinoline-based theranostic ligands for the targeting of fibroblast activation protein[J].J Nucl Med,2018,59(9):1415-1422.
[10]LOKTEV A,LINDNER T,MIER W,et al.A tumor-imaging method targeting cancer-associated fibroblasts[J].J Nucl Med,2018,59(9):1423-1429.
[11]HATHI DK,JONES EF.68Ga FAPI PET/CT:Tracer uptake in 28 different kinds of cancer[J].Radiol Imaging Cancer,2019,1(1):e194003.
[12]MEYER C,DAHLBOM M,LINDNER T,et al.Radiation dosimetry and biodistribution of 68Ga-FAPI-46 PET imaging in cancer patients[J].J Nucl Med,2020,61(8):1171-1177.
[13]CHEN H,ZHAO L,RUAN D,et al.Usefulness of 68Ga-DOTA-FAPI-04 PET/CT in patients presenting with inconclusive 18F-FDG PET/CT findings[J].Eur J Nucl Med Mol Imaging,2021,48(1):73-86.
[14]MEYER C,DAHLBOM M,LINDNER T,et al.Radiation dosimetry and biodistribution of 68Ga-FAPI-46 PET imaging in cancer patients[J].J Nucl Med,2020,61(8):1171-1177.
[15]SAHIN E,ELBOGA U,CELEN YZ,et al.Comparison of 68Ga-DOTA-FAPI and 18F-FDG PET/CT imaging modalities in the detection of liver metastases in patients with gastrointestinal system cancer[J].Eur J Radiol,2021,142:109867.
[16]SHOU Y,XUE Q,YUAN J,et al.68Ga-FAPI-04 PET/MR is helpful in differential diagnosis of pancreatitis from pancreatic malignancy compared to 18F-FDG PET/CT:a case report[J].Eur J Hybrid Imaging,2021,5(1):12.
[17]DENG M,CHEN Y,CAI L.Comparison of 68Ga-FAPI and 18F-FDG PET/CT in the imaging of pancreatic cancer with liver metastases[J].Clin Nucl Med,2021,46(7):589-591.
[18]ZHAO L,CHEN S,LIN L,et al.68Ga-DOTA-FAPI-04 improves tumor staging and monitors early response to chemoradiotherapy in a patient with esophageal cancer[J].Eur J Nucl Med Mol Imaging,2020,47(13):3188-3189.
[19]CHEN H,PANG Y,WU J,et al.Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT for the diagnosis of primary and metastatic lesions in patients with various types of cancer[J].Eur J Nucl Med Mol Imaging,2020,47(8):1820-1832.
[20]PANG Y,ZHAO L,SHANG Q,et al.Positron emission tomography and computed tomography with 68Ga-fibroblast activation protein inhibitors improves tumor detection and staging in patients with pancreatic cancer[J/OL].Eur J Nucl Med Mol Imaging,2022;49(4):1322-1337 [2022-03-10].https://doi.org/10.1007/s00259-021-05576-w.
[21]ARNOLD JN,MAGIERA L,KRAMAN M,et al.Tumoral immune suppression by macrophages expressing fibroblast activation protein-α and heme oxygenase-1[J].Cancer Immunol Res,2014,2(2):121-126.
[22]LUO Y,PAN Q,YANG H,et al.Fibroblast activation protein-targeted PET/CT with 68Ga-FAPI for imaging IgG4-related disease:Comparison to 18F-FDG PET/CT[J].J Nucl Med,2021,62(2):266-271.
[23]ZHANG X,SONG W,QIN C,et al.Non-malignant findings of focal 68Ga-FAPI-04 uptake in pancreas[J].Eur J Nucl Med Mol Imaging,2021,48(8):2635-2641.

备注/Memo

备注/Memo:
中央引导地方科技发展专项资金(编号: 2020ZYD101)
更新日期/Last Update: 2022-10-28