Characteristics of 18F-FAPI-04 PET/CT in patients with peritoneal metastasis and to predict treatment efficacy, a head-to-head comparison with 18F-FDG PET/CT

作者：Yafei Zhang, Mimi Xu, Yu Wang, Fang Yu, Xinxin Chen, Guangfa Wang, Kui Zhao, Hong Yang, Xinhui Su · 发表于：Cancer Imaging · 年份：2025 · DOI：10.1186/s40644-025-00887-9 · 被引用次数：9 · 研究领域：Peptidase Inhibition and Analysis、Heat shock proteins research、Protease and Inhibitor Mechanisms

Abstract Background 18 F-FAPI-04 PET/CT shows promise in detecting peritoneal metastases (PM), but its superiority over 18 F-FDG PET/CT for lesion detection and predicting chemotherapy benefit remains unclear. Purpose To compare 18 F-FAPI-04 and 18 F-FDG PET/CT imaging features in PM and assess predictive value of 18 F-FAPI-04 for chemotherapy efficacy. Methods 39 pathologically confirmed PM patients with digestive malignancies underwent concurrent 18 F-FAPI-04 and 18 F-FDG PET/CT. Semi-quantitative parameters, including SUV max , tumor/liver ratio (T/L), tumor/mediastinal blood pool ratio (T/B), were analyzed. The tracer uptake was compared via Wilcoxon tests. The relationships between 18 F-FAPI-04 uptake with FAP and α-SMA expression were analyzed using Pearson correlation. Patients were divided into different short-term outcome groups (responders vs. non-responders) according to RECIST criteria (v.1.1) after chemotherapy. Post-chemotherapy outcomes were evaluated using logistic regression. Results Patients (median age 62; 16 females, 23 males) included pancreatic ( n = 17), cholangiocarcinoma ( n = 8), gastric ( n = 6), and colorectal cancers ( n = 8). 18 F-FAPI-04 demonstrated significantly higher SUV max , T/L, and T/B than 18 F-FDG ( P < 0.05). Pancreaticobiliary cancers (pancreatic/cholangiocarcinoma) exhibited higher 18F-FAPI-04 uptake than gastroenteric cancers (gastric/colorectal) ( P < 0.05), though no differences existed within subgroups. 18 F-FAPI-04 parame...