Abstract:
Objective To investigate the diagnostic value of 68Ga-fibroblast activation protein inhibitor (FAPI)-04 positron emission tomography and computed tomography (PET/CT) in patients with newly diagnosed pancreatic cancer and its impact on the initial tumor, node, metastasis (TNM) and clinical stagings.
Methods Clinical and imaging data of patients suspected of having pancreatic lesions and admitted to Chongqing University Cancer Hospital between August 2021 and August 2023 were analyzed retrospectively. All the patients underwent conventional CT and 68Ga-FAPI-04 PET/CT. Diagnostic value of 68Ga-FAPI-04 PET/CT in primary and metastatic pancreatic cancers was analyzed using pathological findings or follow-up images as the gold standard. The effect of 68Ga-FAPI-04 PET/CT on TNM and clinical stagings of pancreatic cancer was analyzed and compared with that of conventional CT.
Results A total of 134 patients were included in the study: 127 with pancreatic cancers and 7 with benign lesions. Detection rates of 68Ga-FAPI-04 PET/CT for primary pancreatic cancers, regional lymph node metastasis, and distant metastasis were 100% (127/127), 68.63% (35/51), and 95.35% (41/43), respectively. Median standard uptake value maxium (SUVmax) of pancreatic cancers (14.9) was significantly higher than that of benign pancreatic lesions (6.1) (Z value = -2.921, P= 0.003). TNM staging changed in 32.28% (41/127) pancreatic cancer patients after 68Ga-FAPI PET/CT than in 3.94% (5/127) who underwent conventional CT; consequently, some patients changed their treatment plan.
Conclusions 68Ga-FAPI-04 PET/CT has high diagnostic sensitivity for pancreatic cancer and can detect more cases of distant metastatic lesions and improve M staging compared to that by conventional CT, thereby facilitating a more comprehensive assessment of systemic tumor burden and treatment planning.