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
Abstract Background 18F-FAPI-04 PET/CT shows promise in detecting peritoneal metastases (PM), but its superiority over 18F-FDG PET/CT for lesion detection and predicting chemotherapy benefit remains unclear. Purpose To compare 18F-FAPI-04 and 18F-FDG PET/CT imaging features in PM and assess predicti...
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BMC
2025-06-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-025-00887-9 |
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| author | Yafei Zhang Mimi Xu Yu Wang Fang Yu Xinxin Chen Guangfa Wang Kui Zhao Hong Yang Xinhui Su |
| author_facet | Yafei Zhang Mimi Xu Yu Wang Fang Yu Xinxin Chen Guangfa Wang Kui Zhao Hong Yang Xinhui Su |
| author_sort | Yafei Zhang |
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| description | Abstract Background 18F-FAPI-04 PET/CT shows promise in detecting peritoneal metastases (PM), but its superiority over 18F-FDG PET/CT for lesion detection and predicting chemotherapy benefit remains unclear. Purpose To compare 18F-FAPI-04 and 18F-FDG PET/CT imaging features in PM and assess predictive value of 18F-FAPI-04 for chemotherapy efficacy. Methods 39 pathologically confirmed PM patients with digestive malignancies underwent concurrent 18F-FAPI-04 and 18F-FDG PET/CT. Semi-quantitative parameters, including SUVmax, 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 18F-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). 18F-FAPI-04 demonstrated significantly higher SUVmax, T/L, and T/B than 18F-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. 18F-FAPI-04 parameters positively correlated with FAP and α-SMA expression. In univariate analysis, 18F-FAPI-04 uptake differed significantly between responders and non-responders. Multivariate analysis identified SUVmax as an independent predictor (OR = 1.354, 95%CI:1.025–1.788, P = 0.033). Optimal 18F-FAPI-04 cut-offs for distinguishing outcomes were SUVmax=11.05 (AUC = 0.783; sensitivity = 70.60%, specificity = 80.40%), T/L = 7.53 (AUC = 0.717; 58.82%, 81.82%), and T/B = 8.76 (AUC = 0.751; 64.71%, 86.37%). Conclusion 18F-FAPI-04 PET/CT outperforms 18F-FDG in PM detection, with semi-quantitative parameters predicting chemotherapy response. |
| format | Article |
| id | doaj-art-c89f824e16de40a1bc97a6dd74eab3e5 |
| institution | Kabale University |
| issn | 1470-7330 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj-art-c89f824e16de40a1bc97a6dd74eab3e52025-08-20T03:26:43ZengBMCCancer Imaging1470-73302025-06-0125111210.1186/s40644-025-00887-9Characteristics 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/CTYafei Zhang0Mimi Xu1Yu Wang2Fang Yu3Xinxin Chen4Guangfa Wang5Kui Zhao6Hong Yang7Xinhui Su8Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Pharmacy, The Second Affiliated Hospital of Zhejiang, Chinese Medical UniversityDepartment of Pathology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Radiology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineAbstract Background 18F-FAPI-04 PET/CT shows promise in detecting peritoneal metastases (PM), but its superiority over 18F-FDG PET/CT for lesion detection and predicting chemotherapy benefit remains unclear. Purpose To compare 18F-FAPI-04 and 18F-FDG PET/CT imaging features in PM and assess predictive value of 18F-FAPI-04 for chemotherapy efficacy. Methods 39 pathologically confirmed PM patients with digestive malignancies underwent concurrent 18F-FAPI-04 and 18F-FDG PET/CT. Semi-quantitative parameters, including SUVmax, 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 18F-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). 18F-FAPI-04 demonstrated significantly higher SUVmax, T/L, and T/B than 18F-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. 18F-FAPI-04 parameters positively correlated with FAP and α-SMA expression. In univariate analysis, 18F-FAPI-04 uptake differed significantly between responders and non-responders. Multivariate analysis identified SUVmax as an independent predictor (OR = 1.354, 95%CI:1.025–1.788, P = 0.033). Optimal 18F-FAPI-04 cut-offs for distinguishing outcomes were SUVmax=11.05 (AUC = 0.783; sensitivity = 70.60%, specificity = 80.40%), T/L = 7.53 (AUC = 0.717; 58.82%, 81.82%), and T/B = 8.76 (AUC = 0.751; 64.71%, 86.37%). Conclusion 18F-FAPI-04 PET/CT outperforms 18F-FDG in PM detection, with semi-quantitative parameters predicting chemotherapy response.https://doi.org/10.1186/s40644-025-00887-9Peritoneal metastasesFibroblast activation protein18F-FAPI-04PET/CT |
| spellingShingle | Yafei Zhang Mimi Xu Yu Wang Fang Yu Xinxin Chen Guangfa Wang Kui Zhao Hong Yang Xinhui Su 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 Cancer Imaging Peritoneal metastases Fibroblast activation protein 18F-FAPI-04 PET/CT |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Peritoneal metastases Fibroblast activation protein 18F-FAPI-04 PET/CT |
| url | https://doi.org/10.1186/s40644-025-00887-9 |
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