Fibroblast Activation Protein and Glycolysis in Lymphoma Diagnosis: Comparison of 68 Ga-FAPI PET/CT and 18 F-FDG PET/CT

作者：Xuetao Chen, Shuai Wang, Yumei Lai, Guochang Wang, Maomao Wei, Xiao Jin, Jin Ding, Yan Zhang, Yunfei Shi, Feng Wang, Hua Zhu, Zhi Yang, Xuejuan Wang · 发表于：Journal of Nuclear Medicine · 年份：2023 · DOI：10.2967/jnumed.123.265530 · 被引用次数：38 · 研究领域：Peptidase Inhibition and Analysis、Ubiquitin and proteasome pathways、Cardiac tumors and thrombi

Our objective was to compare the diagnostic performance of 68 Ga-labeled fibroblast activation protein (FAP) inhibitor (FAPI) and 18 F-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 68 Ga-FAPI and 18 F-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. 18 F-FDG PET possessed a higher staging accuracy (98.4%) than 68 Ga‐FAPI PET (86.0%). In 5,980 lymphoma lesions, 18 F-FDG PET/CT detected more nodal (4,624 vs. 2,196) and extranodal (1,304 vs. 845) lesions than 68 Ga-FAPI PET/CT. Additionally, 52 68 Ga-FAPI–positive/ 18 F-FDG–negative lesions and 2,939 68 Ga-FAPI–negative/ 18 F-FDG–positive lesions were observed. In many lymphoma subtypes, semiquantitative evaluation revealed no significant differences in SUV max or target-to-liver ratios between 68 Ga-FAPI and 18 F-FDG PET/CT ( ...