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[ 18 F]FAPI adds value to [ 18 F]FDG PET/CT for diagnosing lymph node metastases in stage I-IIIA non-small cell lung cancer: a prospective study.

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العنوان:	[ ¹⁸ F]FAPI adds value to [ ¹⁸ F]FDG PET/CT for diagnosing lymph node metastases in stage I-IIIA non-small cell lung cancer: a prospective study.
المؤلفون:	Li Y; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China., Zhang Y; Nanfang PET Center, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong Province, China., Guo Z; Department of Thoracic Surgery, Guangzhou Institute of Respiratory Health & China State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou, China., Hou P; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China., Lv J; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China., Ke M; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China., Liu S; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China., Li S; Guangzhou Medical University, Guangzhou, China., Yin W; Department of Thoracic Surgery, Guangzhou Institute of Respiratory Health & China State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou, China., He J; Department of Thoracic Surgery, Guangzhou Institute of Respiratory Health & China State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou, China., Wang X; Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China. 71lu@163.com.
المصدر:	Cancer imaging : the official publication of the International Cancer Imaging Society [Cancer Imaging] 2024 Jun 03; Vol. 24 (1), pp. 68. Date of Electronic Publication: 2024 Jun 03.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Springer Nature Country of Publication: England NLM ID: 101172931 Publication Model: Electronic Cited Medium: Internet ISSN: 1470-7330 (Electronic) Linking ISSN: 14707330 NLM ISO Abbreviation: Cancer Imaging Subsets: MEDLINE
أسماء مطبوعة:	Publication: <2014- > : London : Springer Nature Original Publication: London : e-med, c2000]-
مواضيع طبية MeSH:	Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Fluorodeoxyglucose F18* , Positron Emission Tomography Computed Tomography/methods , Lymphatic Metastasis/diagnostic imaging , Radiopharmaceuticals* , Neoplasm Staging*, Humans ; Middle Aged ; Male ; Female ; Prospective Studies ; Aged ; Adult ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology
مستخلص:	Background: This study investigates the value of fluorine 18 ([ ¹⁸ F])-labeled fibroblast activation protein inhibitor (FAPI) for lymph node (LN) metastases in patients with stage I-IIIA non-small cell lung cancer (NSCLC). Methods: From November 2021 to October 2022, 53 patients with stage I-IIIA NSCLC who underwent radical resection were prospectively included. [ ¹⁸ F]-fluorodeoxyglucose (FDG) and [ ¹⁸ F]FAPI examinations were performed within one week. LN staging was validated using surgical and pathological findings. [ ¹⁸ F]FDG and [ ¹⁸ F]FAPI uptake was compared using the Wilcoxon signed-ranks test. Furthermore, the diagnostic value of nodal groups was investigated. Results: In 53 patients (median age, 64 years, range: 31-76 years), the specificity of [ ¹⁸ F]FAPI for detecting LN metastasis was significantly higher than that of [ ¹⁸ F]FDG (P < 0.001). High LN risk category, greater LN short-axis dimension(≥ 1.0 cm), absence of LN calcification or high-attenuation, and higher LN FDG SUV max (≥ 10.1) were risk factors for LN metastasis(P < 0.05). The concurrence of these four risk factors accurately predicted LN metastases (Positive Predictive Value [PPV] 100%), whereas the presence of one to three risk factors was unable to accurately discriminate the nature of LNs (PPV 21.7%). Adding [ ¹⁸ F]FAPI in this circumstance improved the diagnostic value. LNs with an [ ¹⁸ F]FAPI SUV max <6.2 were diagnosed as benign (Negative Predictive Value 93.8%), and LNs with an [ ¹⁸ F]FAPI SUV max ≥6.2 without calcification or high-attenuation were diagnosed as LN metastasis (PPV 87.5%). Ultimately, the integration of [ ¹⁸ F]FDG and [ ¹⁸ F]FAPI PET/CT resulted in the highest accuracy for N stage (83.0%) and clinical decision revisions for 29 patients. Conclusion: In patients with stage I-IIIA NSCLC, [ ¹⁸ F]FAPI contributed additional valuable information to reduce LN diagnostic uncertainties after [ ¹⁸ F]FDG PET/CT. Integrating [ ¹⁸ F]FDG and [ ¹⁸ F]FAPI PET/CT resulted in more precise clinical decisions. Trial Registration: The Chinese Clinical Trial Registry: ChiCTR2100044944 (Registered: 1 April 2021, https://www.chictr.org.cn/showprojEN.html?proj=123995 ). (© 2024. The Author(s).)
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معلومات مُعتمدة:	2024A03J1160 the Science and Technology Program of Guangzhou; 202201020558 the Science and Technology Program of Guangzhou; 202102010252 the Science and Technology Program of Guangzhou; (No. 82001879 the National Natural Science Foundation of China; A2023233 Guangdong Medical Science and Technology Research Funding
فهرسة مساهمة:	Keywords: FAPI; FDG; Lymph node metastases; Non-small cell lung cancer
المشرفين على المادة:	0Z5B2CJX4D (Fluorodeoxyglucose F18) 0 (Radiopharmaceuticals)
تواريخ الأحداث:	Date Created: 20240603 Date Completed: 20240604 Latest Revision: 20240607
رمز التحديث:	20240607
مُعرف محوري في PubMed:	PMC11145785
DOI:	10.1186/s40644-024-00701-y
PMID:	38831354
قاعدة البيانات:	MEDLINE

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تدمد:	1470-7330
DOI:	10.1186/s40644-024-00701-y