دورية أكاديمية
Preoperative evaluation of mediastinal lymph nodes in non-small cell lung cancer using [ 68 Ga]FAPI-46 PET/CT: a prospective pilot study.
| العنوان: | Preoperative evaluation of mediastinal lymph nodes in non-small cell lung cancer using [ 68 Ga]FAPI-46 PET/CT: a prospective pilot study. |
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| المؤلفون: | Kang YK; Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Na KJ; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea., Park J; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Kwak N; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Lee YS; Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea., Choi H; Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. chy1000@snu.ac.kr.; Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. chy1000@snu.ac.kr.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. chy1000@snu.ac.kr., Kim YT; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. ytkim@snu.ac.kr.; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. ytkim@snu.ac.kr. |
| المصدر: | European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2024 Jul; Vol. 51 (8), pp. 2409-2419. Date of Electronic Publication: 2024 Mar 07. |
| نوع المنشور: | Journal Article; Clinical Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer-Verlag Berlin Country of Publication: Germany NLM ID: 101140988 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1619-7089 (Electronic) Linking ISSN: 16197070 NLM ISO Abbreviation: Eur J Nucl Med Mol Imaging Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer-Verlag Berlin, 2002- |
| مواضيع طبية MeSH: | Carcinoma, Non-Small-Cell Lung*/diagnostic imaging , Carcinoma, Non-Small-Cell Lung*/pathology , Positron Emission Tomography Computed Tomography*/methods , Lung Neoplasms*/diagnostic imaging , Lung Neoplasms*/pathology , Mediastinum*/diagnostic imaging, Humans ; Male ; Female ; Pilot Projects ; Middle Aged ; Aged ; Prospective Studies ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology ; Lymphatic Metastasis/diagnostic imaging ; Neoplasm Staging ; Adult ; Preoperative Period ; Aged, 80 and over ; Quinolines |
| مستخلص: | Purpose: Mediastinal nodal staging is crucial for surgical candidate selection in non-small cell lung cancer (NSCLC), but conventional imaging has limitations often necessitating invasive staging. We investigated the additive clinical value of fibroblast activation protein inhibitor (FAPI) PET/CT, an imaging technique targeting fibroblast activation protein, for mediastinal nodal staging of NSCLC. Methods: In this prospective pilot study, we enrolled patients scheduled for surgical resection of NSCLC based on specific criteria designed to align with indications for invasive staging procedures. Patients were included when meeting at least one of the following: (1) presence of FDG-positive N2 lymph nodes, (2) clinical N1 stage, (3) central tumor location or tumor diameter of ≥ 3 cm, and (4) adenocarcinoma exhibiting high FDG uptake. [ 68 Ga]FAPI-46 PET/CT was performed before surgery after a staging workup including [ 18 F]FDG PET/CT. The diagnostic accuracy of [ 68 Ga]FAPI-46 PET/CT for "N2" nodes was assessed through per-patient visual assessment and per-station quantitative analysis using histopathologic results as reference standards. Results: Twenty-three patients with 75 nodal stations were analyzed. Histopathologic examination confirmed that nine patients (39.1%) were N2-positive. In per-patient assessment, [ 68 Ga]FAPI-46 PET/CT successfully identified metastasis in eight patients (sensitivity 0.89 (0.52-1.00)), upstaging three patients compared to [ 18 F]FDG PET/CT. [ 18 F]FDG PET/CT detected FDG-avid nodes in six (42.8%) of 14 N2-negative patients. Among them, five were considered non-metastatic based on calcification and distribution pattern, and one was considered metastatic. In contrast, [ 68 Ga]FAPI-46 PET/CT correctly identified all non-metastatic patients solely based on tracer avidity. In per-station analysis, [ 68 Ga]FAPI-46 PET/CT discriminated metastasis more effectively compared to [ 18 F]FDG PET/CT-based (AUC of ROC curve 0.96 (0.88-0.99) vs. 0.68 (0.56-0.78), P < 0.001). Conclusion: [ 68 Ga]FAPI-46 PET/CT holds promise as an imaging tool for preoperative mediastinal nodal staging in NSCLC, with improved sensitivity and the potential to reduce false-positive results, optimizing the need for invasive staging procedures. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Fibroblast activation protein; Lung cancer; Mediastinal lymph node; PET/CT; [68Ga]FAPI-46 |
| المشرفين على المادة: | 0 (68Ga-FAPI) 0 (Quinolines) |
| تواريخ الأحداث: | Date Created: 20240307 Date Completed: 20240614 Latest Revision: 20240618 |
| رمز التحديث: | 20240618 |
| مُعرف محوري في PubMed: | PMC11178623 |
| DOI: | 10.1007/s00259-024-06669-y |
| PMID: | 38451308 |
| قاعدة البيانات: | MEDLINE |
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