[18F]F-FAPI PET/CT is superior to [18F]F-FDG PET/CT for lymph node staging in lung cancer: a pathologically validated study - PubMed
2 days ago
- #Lung Cancer Staging
- #PET/CT Imaging
- #Fibroblast Activation Protein
- [18F]F-FAPI PET/CT demonstrated superior diagnostic efficacy over [18F]F-FDG PET/CT for lymph node staging in lung cancer, using histopathology as the reference standard.
- The study included 32 lung cancer patients with FDG-positive lymph nodes, analyzing 71 lymph nodes (23 metastatic, 48 benign) confirmed by surgery or EBUS-TBNA.
- Metastatic lymph nodes showed significantly higher FAPI uptake than benign ones, with an AUC of 0.98 for FAPI versus 0.78 for FDG in ROC analysis.
- [18F]F-FAPI achieved higher specificity (91.7% vs. 16.7%), accuracy (97.0% vs. 43.9%), and PPV (85.2% vs. 36.5%) compared to [18F]F-FDG, with sensitivity and NPV both at 100%.
- Using an SUVmax cut-off greater than 5.3, [18F]F-FAPI correctly identified all metastatic lymph nodes with a 0% false positive rate, versus 83.3% for FDG.
- [18F]F-FAPI improved lymph node staging accuracy to 93.8%, leading to downstaging in 15 patients and potentially avoiding EBUS-TBNA in 42.9% of cases.
- The findings suggest [18F]F-FAPI PET/CT as a promising tool for optimizing invasive staging procedures by reducing false positives in lung cancer.