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European Journal of Medical Research

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Open Access 01-12-2024 | Computed Tomography | Research

¹⁸F-FAPI PET/CT performs better in evaluating mediastinal and hilar lymph nodes in patients with lung cancer: comparison with ¹⁸F-FDG PET/CT

Authors: Yuyun Sun, Yun Sun, Zili Li, Shaoli Song, Kailiang Wu, Jingfang Mao, Jingyi Cheng

Published in: European Journal of Medical Research | Issue 1/2024

Abstract

Background

The aim of this study was to evaluate the efficacy of fluorine 18 (¹⁸F) labeled fibroblast activation protein inhibitor (FAPI) in identifying mediastinal and hilar lymph node metastases and to develop a model to quantitatively and repeatedly identify lymph node status.

Methods

Twenty-seven patients with 137 lymph nodes were identified by two PET/CT images. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of lymph node status were analyzed, and the optimal cut-off value was identified by ROC analysis.

Results

The SUVmax of metastatic lymph nodes on ¹⁸F-FAPI was higher than that on ¹⁸F-FDG PET/CT (10.87 ± 7.29 vs 6.08 ± 5.37, p < 0.001). ¹⁸F-FAPI presented much greater lymph node detection sensitivity, specificity, accuracy, PPV and NPV than ¹⁸F-FDG PET/CT (84% vs. 71%; 92% vs. 67%; 90% vs. 69%, 84% vs. 52%, and 92% vs. 83%, respectively). Additionally, the diagnostic effectiveness of ¹⁸F-FAPI in small lymph nodes was greater than that of ¹⁸F-FDG PET/CT (specificity: 96% vs. 72%; accuracy: 93% vs. 73%; PPV: 77% vs. 33%, respectively). Notably, the optimal cut-off value for specificity and PPV of ¹⁸F-FAPI SUVmax was 5.3; the optimal cut-off value for sensitivity and NPV was 2.5.

Conclusion

¹⁸F-FAPI showed promising diagnostic efficacy in metastatic mediastinal and hilar lymph nodes from lung cancer patients, with a higher SUVmax, especially in small metastatic nodes, compared with ¹⁸F-FDG. In addition, this exploratory work recommended optimal SUVmax cutoff values to distinguish between nonmetastatic and metastatic lymph nodes, thereby advancing the development of image-guided radiation.

Trial registration ClinicalTrials.gov identifier: ChiCTR2000036091.

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Title: 18F-FAPI PET/CT performs better in evaluating mediastinal and hilar lymph nodes in patients with lung cancer: comparison with 18F-FDG PET/CT
Authors: Yuyun Sun
Yun Sun
Zili Li
Shaoli Song
Kailiang Wu
Jingfang Mao
Jingyi Cheng
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Computed Tomography
Computed Tomography
Lung Cancer
Lung Cancer
Lung Cancer
Published in: European Journal of Medical Research / Issue 1/2024
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01494-9

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¹⁸F-FAPI PET/CT performs better in evaluating mediastinal and hilar lymph nodes in patients with lung cancer: comparison with ¹⁸F-FDG PET/CT

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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