Comparison of diagnostic value of quantitative parameters from FAPI and FDG PET/CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer
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Abstract
Objective
This study explores the diagnostic value of quantitative parameters from 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC) patients.
Methods
Seventeen NSCLC patients patients undergoing imaging with FAPI and FDG were included in the study. Measurements were taken for short diameter, long diameter, density of mediastinal lymph nodes, as well as SUVmax of mediastinal blood pool (MBP- SUVmax), primary tumor (PT-SUVmax), and lymph nodes (LN-SUVmax) in both imaging modalities. LN-SUVmax / MBP- SUVmax, LN-SUVmax / PT-SUVmax, and LN-SUVmax /short diameter ratios were calculated for lymph nodes. Statistical differences between the parameters of imaging modalities in the mediastinal lymph node metastasis group and the non-metastasis group were analyzed. Statistical differences between FAPI and FDG imaging parameters were also compared. Receiver Operating Characteristic (ROC) curves were utilized to determine optimal diagnostic thresholds, along with corresponding sensitivity, specificity, and area under the curve (AUC) for each parameter in the detection of mediastinal lymph node metastasis.
Results
In FAPI imaging, LN-SUVmax, LN-SUVmax / MBP- SUVmax, LN-SUVmax / PT-SUVmax, and LN-SUVmax /short diameter were higher in the mediastinal lymph node metastasis group compared to the non-metastasis group, with statistical significance (p < 0.05). In FDG imaging, only LN-SUVmax / PT-SUVmax was higher in the mediastinal lymph node metastasis group, with statistical significance (p < 0.05). Two parameters (LN-SUVmax/MBP-SUVmax, LN-SUVmax/PT-SUVmax) in the FAPI group and three parameters (LN-SUVmax, LN-SUVmax/MBP-SUVmax, LN-SUVmax/short diameter) in the FDG group showed positive and negative correlations, respectively, in the mediastinal lymph node metastasis and non-metastasis groups, all with statistical significance (p < 0.05). The AUC of FAPI imaging for LN-SUVmax (0.907 vs. 0.667) and LN-SUVmax/PT- SUVmax (0.772 vs. 0.704) were higher compared to FDG imaging, with statistical significance (p < 0.05).
Conclusion
68Ga-FAPI-04 PET/CT imaging exhibits a certain advantage over 18F-FDG PET/CT in the detection of mediastinal lymph node metastasis in NSCLC patients, suggesting potential clinical value in the staging of NSCLC patients.
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