Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of...Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor(^(18)F-FAPI-42)and fluorine-18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)for detecting PM of colorectal cancer and to guide clinical decision-making.Methods:Forty-eight patients with PM who underwent both^(18)F-FAPI-42 and^(18)F-FDG PET/CT examinations were studied.The maximum standardized uptake value(SUV max),tumor-to-background ratios(TBRs)and peritoneal cancer index(PCI)of the PM were compared between the two imaging techniques.The intraclass correlation coefficient(ICC)was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI.A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction(complete cytoreduction with no visible disease).Results:The sensitivity and accuracy of^(18)F-FAPI-42 PET/CT for detecting PM were higher than those of^(18)F-FDG PET/CT(82.1%vs 61.1%,P<0.01;84.6%vs 74.5%,P<0.01).The median SUV max and TBR of PM was greater in^(18)F-FAPI-42 than in^(18)F-FDG PET/CT[4.8(1.9-20.1)vs 4.7(1.0-11.0),P=0.02;4.3(1.4-14.6)vs 2.9(0.6-8.0),P<0.01,respectively].The median PCI of PM based on^(18)F-FAPI-42 PET/CT was greater than that based on^(18)F-FDG PET/CT(15 vs 9,P<0.01).The ICC for^(18)F-FAPI-42 PCI was greater than that for^(18)F-FDG PCI(0.915 vs 0.724,P<0.01).The cut-off values of the PCI of the PM for^(18)F-FAPI-42 and^(18)F-FDG PET/CT to predict CC-0 were<18 and<10,with areas under the curve of 0.80 and 0.79,respectively.Conclusions:^(18)F-FAPI-42 PET/CT has superior diagnostic efficacy for PM,particularly in the right upper epigastrium and small intestine.The PCI score of^(18)F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0.The individualized management of PM based on the^(18)F-FAPI-42 PET/CT PCI score is pivotal.展开更多
基金the National Natural Science Foundation of China[grant no.82103084]the Dongguan Science and Technology of Social Development Program[grant no.20231800904303]+6 种基金Z.Z.has received grants from the National Natural Science Foundation of China[no.81901772]the Natural Science Foundation of Guangdong Province[nos 2019A1515011893,2023A1515011300]the State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia&The First People’s Hospital of Kashi Fund[no.SKL-HIDCA-2020-KS2]H.W.has received grants from the Xinjiang Autonomous Region Technology Plan[grant no.2022E02125]The Sixth Affiliated Hospital of Sun Yat-Sen University Clinical Research-1010 Program:1010CG(2022)-08K.Y.has received grants from the National Natural Science Foundation of China[grant no.82300619]the Science and Technology Projects in Guangzhou[grant no.2023A04J2245].
文摘Background:Colorectal cancer is the third-most common type of cancer.When peritoneal metastasis(PM)develops,diagnosing metastatic lesions is difficult and the prognosis is poor.This study aimed to compare the value of fluorine-18 fibroblast activation protein-specific inhibitor(^(18)F-FAPI-42)and fluorine-18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)for detecting PM of colorectal cancer and to guide clinical decision-making.Methods:Forty-eight patients with PM who underwent both^(18)F-FAPI-42 and^(18)F-FDG PET/CT examinations were studied.The maximum standardized uptake value(SUV max),tumor-to-background ratios(TBRs)and peritoneal cancer index(PCI)of the PM were compared between the two imaging techniques.The intraclass correlation coefficient(ICC)was used to compare the consistency between the PET/CT PCI score and the intraoperative PCI.A receiver-operating characteristic curve was used to predict the accuracy of CC-0 cytoreduction(complete cytoreduction with no visible disease).Results:The sensitivity and accuracy of^(18)F-FAPI-42 PET/CT for detecting PM were higher than those of^(18)F-FDG PET/CT(82.1%vs 61.1%,P<0.01;84.6%vs 74.5%,P<0.01).The median SUV max and TBR of PM was greater in^(18)F-FAPI-42 than in^(18)F-FDG PET/CT[4.8(1.9-20.1)vs 4.7(1.0-11.0),P=0.02;4.3(1.4-14.6)vs 2.9(0.6-8.0),P<0.01,respectively].The median PCI of PM based on^(18)F-FAPI-42 PET/CT was greater than that based on^(18)F-FDG PET/CT(15 vs 9,P<0.01).The ICC for^(18)F-FAPI-42 PCI was greater than that for^(18)F-FDG PCI(0.915 vs 0.724,P<0.01).The cut-off values of the PCI of the PM for^(18)F-FAPI-42 and^(18)F-FDG PET/CT to predict CC-0 were<18 and<10,with areas under the curve of 0.80 and 0.79,respectively.Conclusions:^(18)F-FAPI-42 PET/CT has superior diagnostic efficacy for PM,particularly in the right upper epigastrium and small intestine.The PCI score of^(18)F-FAPI-42 PET/CT is very close to the intraoperative PCI score and has a high value for predicting CC-0.The individualized management of PM based on the^(18)F-FAPI-42 PET/CT PCI score is pivotal.
