PDF(Pubmed)
Abstract：
PET/CT using radiolabeled fibroblast activation protein inhibitors (FAPIs) is a promising diagnostic tool in oncology, especially when non-increased and/or physiologically high [18F]FDG uptake (as in liver parenchyma) is observed. We aimed to review the role of PET/CT using radiolabeled FAPIs in primary and/or metastatic liver lesions, and to compare their performances with more \"conventional\" radiopharmaceuticals. A search algorithm based on the terms \"FAPI\" AND (\"hepatic\" OR \"liver\") was applied, with the last update on 1st January 2024. Out of 177 articles retrieved, 76 studies reporting on the diagnostic application of radiolabeled FAPI PET/CT in at least one patient harboring primary or metastatic liver lesion(s) were fully analyzed. Although there was some heterogeneity in clinical conditions and/or study methodology, PET/CT with radiolabeled FAPIs showed an excellent performance in common primary liver malignancies (hepatocarcinoma, intrahepatic cholangiocarcinoma) and liver metastases (mostly from the gastrointestinal tract and lungs). A higher tumor-to-background ratio for FAPIs than for [18F]FDG was found in primary and metastatic liver lesions, due to lower background activity. Despite limited clinical evidence, radiolabeled FAPIs may be used to assess the suitability and effectiveness of FAPI-derived therapeutic agents such as [177Lu]Lu-FAPI. However, future prospective research on a wider population is needed to confirm the excellent performance.
摘要：
使用放射性标记的成纤维细胞活化蛋白抑制剂（FAPI）的PET/CT是肿瘤学中一种有前途的诊断工具，特别是当观察到未增加和/或生理高[18F]FDG摄取(如在肝实质中)时。我们旨在回顾使用放射性标记的FAPI的PET/CT在原发性和/或转移性肝脏病变中的作用，并将它们的性能与更多的“传统”放射性药物进行比较。应用了基于术语“FAPI”AND（“肝”或“肝”）的搜索算法，最后一次更新是在2024年1月1日。在检索到的177篇文章中，全面分析了76项研究，这些研究报告了放射性标记的FAPIPET/CT在至少一名患有原发性或转移性肝病灶的患者中的诊断应用。尽管在临床条件和/或研究方法上存在一些异质性，具有放射性标记的FAPI的PET/CT在常见的原发性肝脏恶性肿瘤（肝癌，肝内胆管癌）和肝转移（主要来自胃肠道和肺）。在原发性和转移性肝脏病变中发现FAPI比[18F]FDG更高的肿瘤背景比，由于较低的背景活动。尽管临床证据有限,放射性标记的FAPI可用于评估FAPI衍生的治疗剂如[177Lu]Lu-FAPI的适用性和有效性。然而,未来需要对更广泛的人群进行前瞻性研究，以证实其优异的表现。
