Purpose

We aimed to compare the staging efficiency of [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT in nasopharyngeal carcinoma (NPC) patients.

Methods

Thirty-nine patients with pathologically confirmed NPC were enrolled in this prospective study. Each patient underwent paired [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-FAPI PET/CT on 2 successive days. The accuracy of two PET/CT for assessing T, N, and M stages was compared by using head-and-neck MRI, histopathologic diagnosis and follow-up results as reference standards. The radiotracer uptake derived from two PETs was also compared.

Results

For treatment-naïve patients, [⁶⁸Ga]Ga-DOTATATE PET/CT showed identical sensitivity for the primary tumours but clearer tumor delineation induced by higher tumour-to-background (TBR) ratio (19.1 ± 8.7 vs. 12.4 ± 7.7, P = 0.003), compared with [⁶⁸Ga]Ga-FAPI PET/CT. Regarding cervical lymph node (CLN) metastases, [⁶⁸Ga]Ga-DOTATATE PET had significantly better sensitivity and accuracy based on neck sides (98% vs. 82%, P < 0.001; 99% vs. 88% P = 0.008), neck levels (98% vs. 78%, 99% vs. 97%; both P < 0.001) and individual nodes (89% vs. 56%, 91% vs. 76%; both P < 0.001), and higher TBR (8.1 ± 4.1 vs. 6.3 ± 3.7, P < 0.001). Additionally, [⁶⁸Ga]Ga-DOTATATE PET/CT revealed higher sensitivity and accuracy for distant metastases (96% vs. 53%, 95% vs. 52%; both P < 0.001), particularly in bone metastases (99% vs. 49%, 97% vs. 49%; both P < 0.001). For post-treatment patients, [⁶⁸Ga]Ga-DOTATATE PET/CT identified one more true-negative case than [⁶⁸Ga]Ga-FAPI PET/CT.

Conclusion

[⁶⁸Ga]Ga-DOTATATE PET/CT performed better than [⁶⁸Ga]Ga-FAPI PET/CT in visualizing the primary tumours, detecting the metastatic lesions and identifying the local recurrence, suggesting [⁶⁸Ga]Ga-DOTATATE PET/CT may be superior to [⁶⁸Ga]Ga-FAPI PET/CT for NPC staging.

中文翻译：

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[68Ga]Ga-DOTATATE 和 [68Ga]Ga-FAPI PET/CT 在鼻咽癌患者中的头对头比较：一项单中心、前瞻性研究

目的

^{我们的目的是比较[ 68} Ga]Ga-DOTATATE 和[ ⁶⁸ Ga]Ga-FAPI PET/CT 在鼻咽癌（NPC）患者中的分期效率。

方法

39 名经病理证实的鼻咽癌患者参加了这项前瞻性研究。每个患者连续两天接受配对的[ ⁶⁸ Ga]Ga-DOTATATE 和[ ⁶⁸ Ga]Ga-FAPI PET/CT。以头颈MRI、组织病理学诊断及随访结果为参考标准，比较两种PET/CT评估T、N、M分期的准确性。还比较了两种 PET 的放射性示踪剂吸收情况。

结果

对于初治患者，[ ^{68 Ga]Ga-DOTATATE PET/CT 对原发肿瘤表现出相同的敏感性，但由于较高的肿瘤与背景 (TBR) 比（19.1 ± 8.7 vs. 12.4 ± 7.7，} P）而导致肿瘤轮廓更清晰= 0.003），与[ ⁶⁸ Ga]Ga-FAPI PET/CT 相比。关于颈部淋巴结（CLN）转移，[ ⁶⁸ Ga]Ga-DOTATATE PET 基于颈侧的敏感性和准确性显着提高（98% vs. 82%，P  < 0.001；99% vs. 88% P =  0.008），颈部水平（98% vs. 78%、99% vs. 97%；均P  < 0.001）和单个淋巴结（89% vs. 56%、91% vs. 76%；均P  < 0.001）以及更高的 TBR（ 8.1 ± 4.1 与 6.3 ± 3.7，P  < 0.001）。此外，[ ⁶⁸ Ga]Ga-DOTATATE PET/CT 显示对远处转移的敏感性和准确性更高（96% vs. 53%、95% vs. 52%；均P  < 0.001），特别是在骨转移中（99% vs. 52%）。 49%、97% 与 49%；均P  < 0.001）。对于治疗后患者，[ ^{68 Ga]Ga-DOTATATE PET/CT 比 [ 68} Ga]Ga-FAPI PET/CT多发现 1 例真阴性病例。

结论

[ ⁶⁸ Ga]Ga-DOTATATE PET/CT在原发肿瘤可视化、检测转移病灶和识别局部复发方面优于[ ^{68 Ga]Ga-FAPI PET/CT，表明[ 68} Ga]Ga-DOTATATE PET/CT对于鼻咽癌分期可能优于[ ^{68 Ga]Ga-FAPI PET/CT。}