18-氟脱氧葡萄糖（18F-FDG）在正电子发射计算机断层扫描/计算机断层扫描（PET/CT）上对病变的摄取可以是良性或恶性的。新的放射标记物，如镓-68（68Ga）标记的成纤维细胞激活蛋白抑制剂-4（FAPI-04），可以用于诊断结肠直肠癌。本研究旨在评估68Ga-FAPI-04 PET在区分18F-FDG亲和结肠病变中的良性和恶性上的功效。通过诱导丙氧甲烷/右旋糖基二硫酸钠（AOM/DSS）的大鼠结肠肿瘤模型建立起来。应用双示踪剂68Ga-FAPI-04和18F-FDG PET/CT在大鼠模型和22例患者中。PET/CT数据通过肠镜、组织病理观察、免疫组织化学（IHC）染色和放射病理显示的结果进行分析。172例病理证实的结肠病变被纳入FAP IHC染色研究。我们发现68Ga-FAPI-04 PET/CT成像能够准确地区分艾滋莫/二硫酸钠诱导的大鼠结肠肿瘤模型中的恶性和良性炎症病变。22例未患有结肠直肠癌的胃癌患者中，有8例在结肠中显示18F-FDG摄取，但这些部位的68Ga-FAPI-04 PET结果为阴性。炎症病变或腺瘤不会对68Ga-FAPI-04 PET成像产生干扰。在18F-FDG亲和的结肠病变中，85.1%（94例中的80例）病理上为恶性病变为FAP阳性，而仅有20.5%（78例中的16例）的前恶性或良性病变显示弱的68Ga-FAPI-04摄取。68Ga-FAPI-04 PET/CT可用于区分18F-FDG亲和结肠病变的良性和恶性。版权所有©2023由Elsevier Inc.出版。

Lesions with a high uptake of 18-fluorodeoxyglucose (18F-FDG) on positron emission tomography / computed tomography (PET/CT) can be benign and malignant. New radiotracers, such as the gallium-68 (68Ga) labeled fibroblast activation protein inhibitor-4 (FAPI-04), could be used to diagnose colorectal carcinoma. This study aimed to evaluate the efficacy of 68Ga-FAPI-04 PET in differentiating benign from malignant in 18F-FDG-avid colorectal lesions.An azoxymethane/dextran sodium sulfate (AOM/DSS) - induced rat colorectal tumor model was developed. Double tracer 68Ga-FAPI-04 and 18F-FDG PET/CT were applied in the rat model and 22 patients. The PET/CT data were analyzed with enteroscopy, histopathological observations, immunohistochemistry (IHC) staining and radioautography results. One hundred seventy-two patients with pathologically confirmed colorectal lesions were enrolled in FAP IHC staining.We found that 68Ga-FAPI-04 PET/CT imaging accurately distinguished the malignancy from benign inflammatory lesions in an AOM/DSS-induced rat colorectal tumor model. Eight out of 22 gastric cancer patients without colorectal carcinoma had 18F-FDG uptake in the colorectum, but 68Ga-FAPI-04 PET was negative in these sites. An inflammatory lesion or adenoma did not interfere with 68Ga-FAPI-04 PET imaging. Among the 18F-FDG-avid colorectal lesions, 85.1% (80 out of 94) of pathologically malignant lesions were FAP-positive, and only 20.5% (16 out of 78) of the premalignant or benign lesions had a week 68Ga-FAPI-04 uptake.68Ga-FAPI-04 PET/CT could be used to distinguish between benign and malignant in 18F-FDG-avid colorectal lesions.Copyright © 2023. Published by Elsevier Inc.