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Jinghua L, Kui X, Deliang G, Bo L, Qian Z, Haitao W, Yaqun J, Dongde W, Xigang X, Ping J, Shengli T, Zhiyong Y, Yueming H, Zhonglin Z, Yong H, Yufeng Y. Clinical prospective study of Gallium 68 ( 68Ga)-labeled fibroblast-activation protein inhibitor PET/CT in the diagnosis of biliary tract carcinoma. Eur J Nucl Med Mol Imaging 2023; 50:2152-2166. [PMID: 36809426 DOI: 10.1007/s00259-023-06137-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE This study is to investigate the [68Ga]Ga-DOTA-FAPI PET/CT diagnosis performance in biliary tract carcinoma (BTC) and analyze the association between [68Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. METHODS A prospective study (NCT05264688) was performed between January 2022 and July 2022. Fifty participants were scanned using [68Ga]Ga-DOTA-FAPI and [18F]FDG PET/CT and acquired pathological tissue. We employed the Wilcoxon signed-rank test to compare the uptake of [68Ga]Ga-DOTA-FAPI and [18F]FDG, and the McNemar test was used to compare the diagnostic efficacy between the two tracers. Spearman or Pearson correlation was used to assess the association between [68 Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. RESULTS In total, 47 participants (mean age 59.09 ± 10.98 [range 33-80 years]) were evaluated. The [68Ga]Ga-DOTA-FAPI detection rate was greater than [18F]FDG in primary tumors (97.62% vs. 85.71%), nodal metastases (90.05% vs. 87.06%), and distant metastases (100% vs. 83.67%). The uptake of [68Ga]Ga-DOTA-FAPI was higher than [18F]FDG in primary lesions (intrahepatic cholangiocarcinoma, 18.95 ± 7.47 vs. 11.86 ± 0.70, p = 0.001; extrahepatic cholangiocarcinoma, 14.57 ± 6.16 vs. 8.80 ± 4.74, p = 0.004), abdomen and pelvic cavity nodal metastases (6.91 ± 6.56 vs. 3.94 ± 2.83, p < 0.001), and distant metastases (pleural, peritoneum, omentum, and mesentery, 6.37 ± 4.21 vs. 4.50 ± 1.96, p = 0.01; bone, 12.15 ± 6.43 vs. 7.51 ± 4.54, p = 0.008). There was a significant correlation between [68Ga]Ga-DOTA-FAPI uptake and fibroblast-activation protein (FAP) expression (Spearman r = 0.432, p = 0.009), carcinoembryonic antigen (CEA) (Pearson r = 0.364, p = 0.012), and platelet (PLT) (Pearson r = 0.35, p = 0.016). Meanwhile, a significant relationship between [68Ga]Ga-DOTA-FAPI metabolic tumor volume and carbohydrate antigen199 (CA199) (Pearson r = 0.436, p = 0.002) was confirmed. CONCLUSION [68Ga]Ga-DOTA-FAPI had a higher uptake and sensitivity than [18F]FDG in the diagnosis of BTC primary and metastatic lesions. The correlation between [68Ga]Ga-DOTA-FAPI PET/CT indexes and FAP expression, CEA, PLT, and CA199 were confirmed. TRIAL REGISTRATION clinicaltrials.gov: NCT 05,264,688.
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Affiliation(s)
- Li Jinghua
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Xu Kui
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Guo Deliang
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Liao Bo
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Zhu Qian
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Wang Haitao
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Jiang Yaqun
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wu Dongde
- Department of Hepatobiliary and Pancreatic Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xia Xigang
- Department of Hepatobiliary Surgery, Jingzhou Central Hospital, Jingzhou, Hubei, China
| | - Jiang Ping
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Tang Shengli
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Yang Zhiyong
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - He Yueming
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China
| | - Zhang Zhonglin
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China.
| | - He Yong
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China.
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
| | - Yuan Yufeng
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
- Clinical Medicine Research Center for Minimally Invasive Procedure of Hepatobiliary &, Pancreatic Diseases of Hubei Province, Wuhan, Hubei, China.
- TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, Hubei, China.
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