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Clinical value of [18F]AlF-NOTA-FAPI-04 PET/CT for assessing early-stage liver fibrosis in adult liver transplantation recipients compared with chronic HBV patients

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Aims

To investigate the clinical value and performance of [18F]AlF-NOTA-FAPI-04 PET/CT in assessing early-stage liver fibrosis in liver transplantation (LT) recipients.

Methods

A prospective study including 17 LT recipients and 12 chronic Hepatitis B (CHB) patients was conducted. All patients received liver biopsy, transient elastography (TE), and [18F]AlF-NOTA-FAPI-04 PET/CT. On [18F]AlF-NOTA-FAPI-04 PET/CT scans, the liver parenchyma’s maximum standardized uptake values (SUVmax) were measured. The receiver operating characteristic (ROC) curve analysis was applied to determine the diagnostic efficacy of [18F]AlF-NOTA-FAPI-04 PET/CT in early-stage liver fibrosis (S1–S2) compared with the diagnostic performance of TE.

Results

Among those 29 patients enrolled in this study, 15(51.7%) had fibrosis S0, 10(34.5%) had S1, and 4(13.8%) had S2, respectively. The SUVmax of patients with early-stage liver fibrosis was significantly higher than those without liver fibrosis in LT recipients and CHB patients (P = 0.004, P = 0.02). In LT recipients, a SUVmax cut-off value of 2.0 detected early-stage liver fibrosis with an AUROC of 0.92 (P = 0.006), and a liver stiffness measurements (LSM) score cut-off value of 8.2 kPa diagnosed early-stage liver fibrosis with an AUROC of 0.80 (P = 0.012). In CHB patients, a SUVmax cut-off value of 2.7 detected early-stage liver fibrosis with an AUROC of 0.94 (P < 0.001) and an LSM scores cut-off value of 8.4 kPa diagnosed early-stage liver fibrosis with an AUROC of 0.91 (P < 0.001).

Conclusion

[18F]AlF-NOTA-FAPI-04 PET/CT could be applied to evaluate early-stage liver fibrosis in LT recipients and CHB patients properly, with the potential additional advantages in monitoring and predicting complications after LT.

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Acknowledgements

We thank all the staff working in the Liver Disease Center, Department of Organ Transplantation, Department of Pathology, Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University.

Funding

This study is supported by Shandong Province Social Science Popularization and Application Research Project (2021-SKZC-18).

Author information

Author notes

  1. Wei Rao, Xiao-han Fang, and Youwei Zhao contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Division of Hepatology, Liver Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Wei Rao & Jin-zhen Cai

  2. Department of Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Wei Rao & Jin-zhen Cai

  3. Institute of Organ Donation and Transplantation of Qingdao University Medical College, Qingdao, 266000, Shandong, China

    Wei Rao & Jin-zhen Cai

  4. Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Xiao-han Fang, Youwei Zhao, Xinjuan Kong & Man Xie

  5. Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Ye Wang & Zhimin Wei

  6. Department of Immunology, Medical College of Qingdao University, Qingdao, 266000, Shandong, China

    Bei Zhang

  7. Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Guangjie Yang

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  1. Wei Rao
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Contributions

RW: formal analysis, writing—original draft. FX-h: methodology, writing—editing. ZY: data curation, investigation. WY: data collection, methodology. ZB: methodology, writing—editing. WZ: data collection, methodology. KX-j: methodology, supervision. YG: data curation, methodology, study guiding. CJ-z: project administration. XM: funding acquisition, conceptualization, writing—review and editing.

Corresponding authors

Correspondence to Guangjie Yang or Man Xie.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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This study was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (QYFY WZLL 27886).

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Written informed consent was obtained from all participants.

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Rao, W., Fang, Xh., Zhao, Y. et al. Clinical value of [18F]AlF-NOTA-FAPI-04 PET/CT for assessing early-stage liver fibrosis in adult liver transplantation recipients compared with chronic HBV patients. Jpn J Radiol 42, 536–545 (2024). https://doi.org/10.1007/s11604-024-01528-0

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