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Objective To evaluate the clinical value of 18F-fibroblast-activation protein inhibitor (18F-FAPI) PET/CT in malignant tumors exhibiting low uptake of 18F-fluorodeoxyglucose (18F-FDG). Methods We prospectively analyzed 62 patients with malignant tumors and low 18F-FDG uptake who underwent 18F-FAPI PET/CT in the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from January 2021 to November 2022. Patient demographics information, clinical and radiological data were collected. Tumor lesions were categorized based on 18F-FAPI and 18F-FDG uptake relative to surrounding tissues into low-, moderate-, and high-uptake, with high uptake indicating positivity. The number and tracer uptake levels of primary tumors and metastatic lesions visualized by both 18F-FDG and 18F-FAPI were recorded and compared. Results Of the 62 primary tumors, 18(29.0%) showed low-uptake and 44 (71.0%) moderate-uptake on 18F-FDG PET, while 1(1.6%), 6(9.7%), and 55(88.7%) showed low, moderate, and high uptake on 18F-FAPI, respectively. The maximum standardized uptake value (SUVmax) for primary tumors was significantly higher with 18F-FAPI than with 18F-FDG (7.5±5.6 vs. 3.9±2.1, P<0.01). The number of positive lymph node foci revealed by 18F-FAPI was noticeably higher than that by 18F-FDG (77 vs. 38, P<0.01). A total of 16 distant organ metastases were identified, with 11(68.8%) detected by 18F-FDG and 15(93.8%) by 18F-FAPI, showing no significant difference in detection rates (P>0.05). Conclusions 18F-FAPI PET/CT effectively visualizes primary and metastatic lesions in malignant tumors with low 18F-FDG uptake, suggesting its potential as a promising radiotracer for such malignancies.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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