Abstract
Purpose:The aim of this study is to explore the nodule characterization and staging efficacy of [68Ga]Ga-DOTA-FAPI-04 PET/CT in non-small cell lung cancer (NSCLC) patients and to compare with that of [18F]FDG PET/CT lesion-by-lesion.Methods:Sixty-five patients with clinically diagnosed or suspected NSCLC were enrolled in this prospective study (ChiCTR2000038080). All patients received both [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT, and they were assigned into three groups by different research directions as nodule characterization, node (N) staging and metastatic (M) staging. Imaging characteristics in PET/CT of lung nodules and suspected metastatic lesions were obtained and analyzed.Results:In the nodule characterization group, [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 SUVmax ≥ 2.5 was set as the predictor of NSCLC, and the diagnostic sensitivity of [68Ga]Ga-DOTA-FAPI-04 was higher than [18F]FDG (0.88 vs. 0.67). And for adenocarcinoma with partial-solid density, SUVmax of 68Ga-DOTA-FAPI-04 was higher than [18F]FDG with significant differences (4.8 ± 2.8 vs. 2.1 ± 1.1). In N staging group, lymph nodes SUVmax of [68Ga]Ga-DOTA-FAPI-04 was lower than [18F]FDG in nonmetastatic group (3.1 ± 1.3 vs. 6.1 ± 2.3) and higher than [18F]FDG (10.7 ± 4.7 vs. 6.5 ± 3.3) in metastatic group. Set 6 and 1.1 as the cut-off value for [68Ga]Ga-DOTA-FAPI-04 SUVmax and [68Ga]Ga-DOTA-FAPI-04 SUVmax/FDG SUVmax, diagnostic accuracy of metastatic lymph nodes using each criterion and their combination was 95%, 93% and 97% respectively. In multi-metastatic NSCLC patients, [68Ga]Ga-DOTA-FAPI-04 identified more lesions than [18F]FDG (206 vs. 106 lesions) and the uptake value of [68Ga]Ga-DOTA-FAPI-04 was higher too, but no patients’ staging was changed.Conclusion:Compared with [18F]FDG, [68Ga]Ga-DOTA-FAPI-04 PET/CT imaging has higher sensitivity in primary and metastatic lesion detection of NSCLC patients, it also increases the specificity of metastatic lymph nodes diagnosis.
Preoperative Standardized Uptake Value of Metastatic Lymph Nodes Measured by 18F-FDG PET/CT Improves the Prediction of Prognosis in Gastric Cancer