^(68)Ga-FAPI-04 PET/CT在胰腺癌与胰腺炎鉴别诊断中的价值

目的:探讨^(68)Ga-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^(68)Ga-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SUV_(max)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SUV_(max)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SUV_(max)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,SUV_(max)分界值为6.45,此时^(68)Ga-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SUV_(max)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SUV_(max)值呈正相关关系。结论:^(68)Ga-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。

Application of 68Ga-FAPI-04 PET/CT in differential diagnosis of pancreatic cancer and pancreatitis

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.