ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1500273
This article is part of the Research TopicAdvancing Cancer Imaging Technologies: Bridging the Gap from Research to Clinical PracticeView all 15 articles
Added Value of Dual-phase 99mTc-HYNIC-FAPI-04 SPECT/CT in Postoperative Follow-up of Colorectal Cancer
Provisionally accepted
- 1Yangpu Hospital, Tongji University, Yangpu, China
- 2Department of Navy Environmental and Occupational Health, Faculty of Naval Medicine, Naval Medical University, Shanghai, Shanghai, China
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Objective: To assess the added value of dual-phase 99m Tc-HYNIC-FAPI-04 single-photon emission computed tomography/computed tomography (SPECT/CT) compared with single-phase imaging in postoperative follow-up of colorectal cancer (CRC).Early and delayed 99m Tc-HYNIC-FAPI-04 SPECT/CT imaging were undertaken in 21 patients with CRC after surgery. The mean radioactivity count of the lesion site and abdominal aorta in secondary imaging was delineated and measured. The early and delayed target background ratio (TBR) and retention index (RI) were calculated, respectively. The results of biopsy or postoperative pathology, clinical and imaging follow-up were used as the "gold standard" of tumor metastasis.Lesions were divided into "benign" and "malignant" groups. The uptake rate and metabolic rate of 99m Tc-HYNIC-FAPI-04 in the two groups were observed. The diagnostic efficiency of early imaging, delayed imaging, and their combination for prediction of benign and malignant lesions was compared using receiver operating characteristic (ROC) curves.Results: Fifty-five lesions with abnormal uptake of 99m Tc-HYNIC-FAPI-04 were found by SPECT/CT. Compared with TBR-early, TBR-delayed in malignant group was increased (4.07±1.65 vs. 4.36±1.86, P = 0.040), whereas TBR-delayed in the benign group was decreased significantly (2.96±0.85 vs. 2.66±0.77, P < 0.001). The mean count of radioactivity in the delayed phase, TBRearly, TBR-delayed, and RI in the malignant group were higher than those in the benign group (P = 0.005, <0.001, and <0.001, respectively). ROC curves showed that combined application of TBRearly, TBR-delayed, and RI had an AUC of 0.889, specificity of 0.900, and sensitivity of 0.844, and its diagnostic efficiency was superior to that of TBR-delayed (P = 0.026) and TBR-early (P <0.001).Conclusions: Dual-phase 99m Tc-HYNIC-FAPI-04 SPECT/CT could be used for the detection of metastatic lesions after CRC surgery. It has a higher auxiliary role than single-phase imaging for the differential diagnosis of benign and malignant lesions after CRC surgery.
Keywords: 99mTc -HYNIC-FAPI-04, SPECT/CT, Dual-phase imaging, colorectal cancer, Postoperative monitoring
Received: 23 Sep 2024; Accepted: 27 May 2025.
Copyright: © 2025 Wang, Sun, Liu, Hou, Li and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yingqiu Wang, Yangpu Hospital, Tongji University, Yangpu, China
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