Ga-FAPI Uptake Correlates Nrog Lub Xeev Ntawm Kab Mob Raum Hniav

Abstract

Txoj Kev Hauv 81 cov neeg mob tau txais ib qho ntawm cov kev sojntsuam hauv qab no, [68 Ga]Ga-FAPI, [68 Ga]Ga-PSMA, lossis [68 Ga]Ga-DOTATOC, lub raum tsis ua haujlwm tau cuam tshuam nrog SUVmax thiab SUVmean ntawm Lub raum parenchyma thiab keeb kwm kev ua haujlwm ntsuas hauv lub ntsws parenchyma, myocardium, cov leeg gluteal, thiab lub plab aorta. Cov neeg mob tau muab faib ua pawg raws li lawv cov kab mob raum tsis zoo (CKD) qib, thiab kev soj ntsuam rov qab thiab ib-txoj kev ANOVA tau ua nyob rau hauv qhov kev tshuaj xyuas rov qab no.

Tshuaj ntsuab FORMULA FOR KIDNEY HEALTH PROBLEM

Taw qhia

Lub raum fibrosisyog amob ntevnrog rau kev pheej hmoo ntawm kev puas tsuaj sai rau lub raum tsis ua haujlwm thiab xav tau kev lim ntshav thiab muaj kev pheej hmoo siab dua. Cov kab mob raum tsis zoo (CKD) txhais tau tias yog lub raum puas lossis tsis pom kev glomerular pom tus nqi ((GFR) < 60 mL / min / 1.73 m2 ) rau tsawg kawg 3 lub hlis, txawm tias ua rau [1]. Yog li, GFR, albuminuria, thiab cov cuab yeej kuaj mob xws li ultrasound thiab suav tomography los ntsuas lub raum qauv yog cov khoom tseem ceeb hauv kev kuaj mob CKD [2]. Kev kuaj mob ntxov yog qhov tseem ceeb kom ua tiav qhov kev pom zoo dua thiab kev kho mob thaum ntxov / kho tus kab mob (xws li, kub siab, ntshav qab zib mellitus, mob glomerulonephritis). Cov cuab yeej siv tshuaj ntsuam xyuas tam sim no rau kev kuaj pom lub raum fibrosis yog qhov cuam tshuam thiab yuav tsum tau ua tiav ntawm biopsy ua raws li kev lees paub histological. Cov tom kawg muaj nws cov kev pheej hmoo cuam tshuam, yog qhov xav tau heev rau tus neeg mob, thiab siv sijhawm ntev. Yog li ntawd, qhov kev xav tau loj hlob rau qhov tsis tshua muaj kev cuam tshuam thiab nrawm dua kev kuaj mob.

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Nws paub tias nyob rau theem pib ntawm lub raum fibrosis, kev txuam ntawm fibroblasts tshwm sim hauv lub raum parenchyma [9]. Ntau qhov kev tshawb fawb tau pom tias cov xov tooj cua [68 Ga] Ga-FAPI khi rau fibroblast-activation-protein (FAP) hauv fibroblasts ntawm cov qog nqaij hlav [10]. Qhov kev sib khi ntawm FAP no kuj tshwm sim hauv cov ntaub so ntswg uas tsis yog qog xws li hauv cov kab mob siab fibrotic [11]. Txoj cai khi tau siv rau hauv txoj kev tshawb no los tshuaj xyuas seb qhov kev qhia ntawm FAP khi ntawm [68 Ga]Ga-FAPI hauv cov ntaub so ntswg raum-parenchymal cuam tshuam nrog CKD theem ntawm cov neeg mob. Txoj kev tshawb fawb saum toj no (Zhou et al., 2021) twb tuaj yeem qhia tau tias lub tswv yim ntawm FAP qhia ua haujlwm rau CKD; Txawm li cas los xij, tsis muaj qhov sib piv rau cov pab pawg noj qab haus huv suav nrog.

Qhov thib ob radiotracer soj ntsuam hauv txoj kev tshawb no yog [68 Ga] Ga-DOTATOC. Cov compound yog octreotide DOTA-conjugated peptide uas tuaj yeem khi rau somatostatin receptors (SSTRs) nrog lub siab nyiam ntawm SST-2 receptor [12]. Nws tau raug pom tias cov kab mob raum muaj qhov nce ntxiv ntawm somatostatin receptor qhia [13]. Rau lub hauv paus no, peb tau tshawb xyuas seb puas muaj kev sib raug zoo ntawm kev sib raug zoo ntawm [68 Ga]Ga-DOTATOC hauv lub raum parenchyma thiab theem ntawm cov kab mob raum, yog li seb lub xov tooj cua no puas muaj peev xwm kuaj xyuas lub raum fibrosis.

Prostate-specific membrane antigen (PSMA) feem ntau khi rau cov ntaub so ntswg prostate, uas qhia txog kev nthuav dav hauv cov qog nqaij hlav [14]. Yog li, nws tau txais dav los ua lub hom phiaj rau kev kuaj pom thiab radionuclide kho mob qog noj ntshav prostate [15]. Tsis tas li ntawd, PSMA physiologically khi rau cov hlwb ntawm cov tubules ze ze ntawm lub raum, nrog rau cov qog nqaij hlav thiab cov nqaij hlwb [16]. Yog li ntawd, nws cov physiological tsub zuj zuj nyob rau hauv lub raum yuav ua tau raws li ib tug diagnostic kev sib raug zoo rau cov kab mob raum.

Kev kawm thiab cov txheej txheem

Kawm tsim qauv

[68 Ga]Ga-DOTATOC tau ua haujlwm hauv 27 tus neeg mob, 16 tus txiv neej thiab 11 tus poj niam uas muaj hnub nyoog nruab nrab ntawm 64 xyoo. Cov ntaub ntawv ntxiv ntawm tag nrho cov neeg mob thiab cov yam ntxwv ntawm tus neeg mob tau tshwm sim hauv Table 1, thiab rau txhua tus neeg taug qab tus nqi, tus naj npawb ntawm cov neeg mob nrog rau theem tau teev tseg.

Table 1 Tag nrho cov neeg mob ntawm txhua pawg CKD hauv cov pab pawg xov tooj cua sib txawv

PET/CT imaging thiab radiotracer synthesis

Synthesis and labeling of [ 68 Ga]Ga-FAPI-04 and [ 68 Ga]Ga FAPI-46 twb tau piav yav tas los [17, 18]. Cov duab PET/CT hauv Heidelberg rau [68 Ga]Ga-FAPI tau ua piv txwv rau PET/CT raws tu qauv uas tau piav los ntawm Kratochwil li al. [10] siv Biograph mCT Flow scanner (Siemens). Ua raws li cov kev cai ntawm German Pharmaceuticals Act §13(2b), qhov taw qhia rau kev kuaj xyuas thiab sau npe ntawm FAPI tracers tau ua raws li lub luag haujlwm ncaj qha ntawm tus kws kho mob thov.

Cov kev txhaj tshuaj rau [68 Ga] Ga-FAPI kev xeem tau suav nrog kev txhaj tshuaj ntau ntawm 113–340 MBq. Kev kuaj PET tau pib 1 teev tom qab txhaj tshuaj, thiab cov neeg mob tau kuaj xyuas hauv kev coj ua craniocaudal. Cov neeg mob tau txais 2 MBq / kg lub cev hnyav xws li [68 Ga] Ga-DOTATOC lossis [68 Ga]Ga-PSMA (University Hospital RWTH Aachen) thiab tau kuaj 60 feeb tom qab txhaj tshuaj. Kev nrhiav tau tus tsiaj / CT tau ua tiav ntawm Philips Gemini TF 16 PET / CT (Philips Medical Systems, Zoo Tshaj Plaws, Lub Netherlands). Cov neeg mob tau kuaj xyuas hauv craniocau dal orientation rau [68 Ga]Ga-DOTATOC thiab caudocranial orientation rau [68 Ga]Ga-PSMA nrog lawv txhais caj npab tsa kom txo cov nqaj-hardening artifacts. Ua ntej, ib qho tshuaj qis tag nrho lub cev CT los ntawm lub hauv paus ntawm pob txha taub hau mus rau sab sauv tau ua yam tsis muaj qhov sib txawv nruab nrab rau kev kho kom haum. CT parameters rau cov koob tshuaj qis tsis tau kho CT tau siv analog rau cov txheej txheem los ntawm Behrendt li al. [19].

Lub 68 Ga-PSMA-HBED-CC tracer rau PET / CT scans yog tsim los ntawm lub tsev muag tshuaj hauv tsev siv ib txoj kev qhia yav dhau los [20]. Raws li [68 Ga]Ga-DOTATOC, nws tau raug tsim los siv cov cassette-based synthesis module GRP-3 V los ntawm Scintomics [21].

Clinical PET/CT imaging thiab cov ntaub ntawv tsom xam

Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau txheeb xyuas cov duab PET, kom pom qhov nce ntawm cov xov tooj cua hauv qhov chaw tau txiav txim siab ua ntej. Txhawm rau kom pom qhov pom kev zoo dua ntawm lub cev, PET cov duab tau fused nrog lub cev qis CT. Lub raum uptake ntawm tag nrho peb radiotracers yog quant pub siv SUVmax (tus qauv uptake tus nqi siab tshaj plaws) thiab SUVmean (tus qauv uptake tus nqi txhais tau tias) ntawm qhov chaw ntawm lub raum parenchyma (superior, nruab nrab, thiab inferior lub raum cortex) raws li illustrated nyob rau hauv daim duab 1. Tom qab Kev ua haujlwm tau raug ntsuas hauv lub ntsws parenchyma, myocardium, thiab cov leeg gluteal thiab suav nrog cov dej ua si uas tau ntsuas hauv plab aorta ntawm qib ntawm lub raum cov hlab ntsha.