Objective This study aimed to compare the value of [68 Ga]Ga-FAPI-04 PET/CT with X-ray imaging in assessing disease activity and treatment response in patients with rheumatoid arthritis (RA). Method All patients underwent clinical and laboratory assessments, [68 Ga]Ga-FAPI-04 PET/CT, and X-ray imaging, with a 6-month follow-up to assess disease activity and treatment response. Bland–Altman analysis assessed the agreement between PET/CT and X-ray parameters. Correlation analyses were performed between clinical characteristics and imaging parameters. Receiver operating characteristic (ROC) curve analyses were used to predict treatment response. Results We prospectively enrolled 17 patients with RA (14 females and 3 males; median age, 55.0 yr [IQR: 50.0–58.5 yr]). [68 Ga]Ga-FAPI-04 PET/CT showed strong agreement with X-ray in evaluating the number of joints involved. PET/CT imaging-derived parameters, including PET joint count (PJCFAPI), PET articular index (PAIFAPI), total synovitis uptake (TSUFAPI), and metabolic synovitis volume (MSVFAPI) were significantly correlated with C-reactive protein levels. Moreover, PJCFAPI and PAIFAPI were associated with tender or swollen joint count (TJC/SJC), disease activity score with 28-joint counts (DAS28), and Simplified Disease Activity Index (SDAI), respectively. No correlations were observed between the X-ray findings and disease activity parameters. The baseline PAIFAPI > cutoff values could discriminate responders and non-responders at the 6-month follow-up according to the Clinical Disease Activity Index (CDAI) and SDAI response criteria, while X-ray could not predict treatment response. Conclusions [68 Ga]Ga-FAPI-04 PET/CT was superior to X-ray imaging in evaluating disease activity and predicting treatment response in patients with RA. Trial registration ClinicalTrials. NCT04514614. Registered 13 August 2020, <a href="https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p">https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p</a>

Comparisons of [⁶⁸ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in the assessment of patients with rheumatoid arthritis

期刊论文
发表日期：

2025年4月28日

查看全文

Dan Yang,
Jiana Chen,
Guangyuan He,
Ziyue Zhou,
Jiaqi Xu,
Yezi Peng,
Xiangyi Shen,
Xu Jiang,
Qingqing Pan,
Lidan Zhao,
Yunyun Fei,
Yaping Luo,
Huaxia Yang

摘要

Objective

This study aimed to compare the value of [⁶⁸ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in assessing disease activity and treatment response in patients with rheumatoid arthritis (RA).

Method

All patients underwent clinical and laboratory assessments, [⁶⁸ Ga]Ga-FAPI-04 PET/CT, and X-ray imaging, with a 6-month follow-up to assess disease activity and treatment response. Bland–Altman analysis assessed the agreement between PET/CT and X-ray parameters. Correlation analyses were performed between clinical characteristics and imaging parameters. Receiver operating characteristic (ROC) curve analyses were used to predict treatment response.

Results

We prospectively enrolled 17 patients with RA (14 females and 3 males; median age, 55.0 yr [IQR: 50.0–58.5 yr]). [⁶⁸ Ga]Ga-FAPI-04 PET/CT showed strong agreement with X-ray in evaluating the number of joints involved. PET/CT imaging-derived parameters, including PET joint count (PJC_FAPI), PET articular index (PAI_FAPI), total synovitis uptake (TSU_FAPI), and metabolic synovitis volume (MSV_FAPI) were significantly correlated with C-reactive protein levels. Moreover, PJC_FAPI and PAI_FAPI were associated with tender or swollen joint count (TJC/SJC), disease activity score with 28-joint counts (DAS28), and Simplified Disease Activity Index (SDAI), respectively. No correlations were observed between the X-ray findings and disease activity parameters. The baseline PAI_FAPI > cutoff values could discriminate responders and non-responders at the 6-month follow-up according to the Clinical Disease Activity Index (CDAI) and SDAI response criteria, while X-ray could not predict treatment response.

Conclusions

[⁶⁸ Ga]Ga-FAPI-04 PET/CT was superior to X-ray imaging in evaluating disease activity and predicting treatment response in patients with RA.

Trial registration

ClinicalTrials. NCT04514614. Registered 13 August 2020, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p

Comparisons of [68 Ga]Ga-FAPI-04 PET/CT with X-ray imaging in the assessment of patients with rheumatoid arthritis

摘要

Comparisons of [⁶⁸ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in the assessment of patients with rheumatoid arthritis