Head-to-head comparison of 18F-FAPI and 18F-FDG PET/CT in staging and therapeutic management of hepatocellular carcinoma

作者：Jing Zhang, Shuqin Jiang, Mengsi Li, Haibao Xue, Xi Zhong, Shuyi Li, Hao Peng, Jiuceng Liang, Zhidong Liu, Songquan Rao, Haipeng Chen, Zewen Cao, Yuanfeng Gong, Guoshuo Chen, Rusen Zhang, Linqi Zhang · 发表于：Cancer Imaging · 年份：2023 · DOI：10.1186/s40644-023-00626-y · 被引用次数：53 · 研究领域：Peptidase Inhibition and Analysis、Cardiac Structural Anomalies and Repair、Protease and Inhibitor Mechanisms

Abstract Background Fluorine 18 ( 18 F) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has limitations in staging hepatocellular carcinoma (HCC). The recently introduced 18 F-labeled fibroblast-activation protein inhibitor (FAPI) has shown promising prospects in detection of HCC lesions. This study aimed to investigate the initial staging and restaging performance of 18 F-FAPI PET/CT compared to 18 F-FDG PET/CT in HCC. Methods This prospective study enrolled histologically confirmed HCC patients from March 2021 to September 2022. All patients were examined with 18 F-FDG PET/CT and 18 F-FAPI PET/CT within 1 week. The maximum standard uptake value (SUV max ), tumor-to-background ratio (TBR), and diagnostic accuracy were compared between the two modalities. Results A total of 67 patients (57 men; median age, 57 [range, 32–83] years old) were included. 18 F-FAPI PET showed higher SUV max and TBR values than 18 F-FDG PET in the intrahepatic lesions (SUV max : 6.7 vs. 4.3, P < 0.0001; TBR: 3.9 vs. 1.7, P < 0.0001). In diagnostic performance, 18 F-FAPI PET/CT had higher detection rate than 18 F-FDG PET/CT in intrahepatic lesions [92.2% (238/258) vs 41.1% (106/258), P < 0.0001] and lymph node metastases [97.9% (126/129) vs 89.1% (115/129), P = 0.01], comparable in distant metastases [63.6% (42/66) vs 69.7% (46/66), P > 0.05]. 18 F-FAPI PET/CT detected primary tumors in 16 patients with negative 18 F-FDG, upgraded T-stages in 12 patients...