AUTHOR=Sun Donghua , Ma Li , Liu Yan , Bao Caili , Jia Guorong , Wang Tao , Wang Yingqiu 

TITLE=99mTc-FAPI-04 SPECT/CT outperforms contrast-enhanced CT in detecting metastasis in postoperative patients with colorectal cancer

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1462870

DOI=10.3389/fmed.2024.1462870

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Purpose</title><p>To compare the performance of <sup>99m</sup>Tc-FAPI-04 SPECT/CT and contrast-enhanced CT (CECT) in the detection of postoperative metastasis in patients with colorectal cancer (CRC).</p></sec><sec id="sec2"><title>Methods</title><p>The postoperative patients with CRC were consecutively recruited from January 2023 to June 2023, and the enrolled patients completed <sup>99m</sup>Tc-FAPI-04 SPECT/CT imaging and CECT examination within two weeks. Histopathological analysis and the follow-up results were used as the reference criteria. The location and number of metastatic sites and the detection accuracy between the two imaging methods were compared. The tumor-to-background ratio (TBR) of liver metastasis and lymph node metastasis in <sup>99m</sup>Tc-FAPI-04 SPECT/CT imaging were also calculated for comparison.</p></sec><sec id="sec3"><title>Results</title><p>In total, 19 postoperative CRC patients, including 15 patients with metastasis, were included in this study. In the patient-based analysis, <sup>99m</sup>Tc-FAPI-04 SPECT/CT showed a significantly higher sensitivity for the detection of metastasis than CECT (93.3% vs. 80.0%, <italic>p</italic> = 0.038), but both techniques had the same specificity (100%, 4/4). For the lesion-based analysis, the detection rates of metastatic sites were 92.2% (47/51) and 72.5% (37/51) for <sup>99m</sup>Tc-FAPI-04 SPECT/CT and CECT, respectively, and the difference between them was statistically significant. In the diagnosis of liver metastasis and lymph node metastasis, <sup>99m</sup>Tc-FAPI-04 SPECT/CT both exceeded CECT. Additionally, the TBR in lymph node metastasis was higher than that in liver metastasis.</p></sec><sec id="sec4"><title>Conclusion</title><p>The findings suggested that <sup>99m</sup>Tc-FAPI-04 SPECT/CT could detect metastasis more effectively than CECT, especially liver and lymph node metastases, in postoperative CRC patients.</p></sec>