Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors

PurposeThis study compared the diagnostic performance, semi-quantitative capability, and staging accuracy of [18F]AlF-NOTA-FAPI-04 and [18F]FDG PET/CT in detecting lymph node metastases.MethodsThis single-center retrospective study included 41 patients with suspected lymph node metastases who receiv...

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Príomhchruthaitheoirí: Wanjing Zhou, Jiashun Dai, Kai Zheng, Xiang Peng, Yanyin Zhang, Chengzhi Jiang, Jian Yang, Hui Ye
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Teanga:Béarla
Foilsithe / Cruthaithe: Frontiers Media S.A. 2025-07-01
Sraith:Frontiers in Oncology
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Rochtain ar líne:https://www.frontiersin.org/articles/10.3389/fonc.2025.1605568/full
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author Wanjing Zhou
Jiashun Dai
Kai Zheng
Xiang Peng
Yanyin Zhang
Chengzhi Jiang
Jian Yang
Hui Ye
author_facet Wanjing Zhou
Jiashun Dai
Kai Zheng
Xiang Peng
Yanyin Zhang
Chengzhi Jiang
Jian Yang
Hui Ye
author_sort Wanjing Zhou
collection DOAJ
description PurposeThis study compared the diagnostic performance, semi-quantitative capability, and staging accuracy of [18F]AlF-NOTA-FAPI-04 and [18F]FDG PET/CT in detecting lymph node metastases.MethodsThis single-center retrospective study included 41 patients with suspected lymph node metastases who received both [18F]FDG and [18F]AlF-NOTA-FAPI-04 PET/CT. The study compared metastatic lymph node detection, semi-quantitative values, and N staging accuracy. Subgroup analyses were performed for lymph nodes with short-axis diameters (SADs) ≥10 and <10 mm.ResultsA total of 41 patients with 126 nodes were included. [18F]AlF-NOTA-FAPI-04 outperformed [18F]FDG in the detection of metastatic lymph nodes, achieving higher accuracy in both patient-based (92.7% vs. 70.7%, p = 0.004) and node-based analyses (91.3% vs. 60.3%, p < 0.001). In semi-quantitative analysis, the maximum standardized uptake value and target-to-background ratio of [18F]AlF-NOTA-FAPI-04 were higher than those of [18F]FDG in metastatic lymph nodes (all p < 0.001). Both tracers distinguished metastatic from benign nodes with SAD ≥ 10 mm (p < 0.05). [18F]AlF-NOTA-FAPI-04 PET/CT could distinguish between benign and metastatic lymph nodes with SAD < 10 mm (p < 0.001), whereas [18F]FDG PET/CT could not (p > 0.05). [18F]AlF-NOTA-FAPI-04 also provided more accurate N staging assessments (87.8% vs. 65.9%, p = 0.006). [18F]AlF-NOTA-FAPI-04 PET/CT enabled the correct diagnosis of more lymph nodes, leading to a change in the therapeutic regimen for eight patients (19.5%).Conclusion[18F]AlF-NOTA-FAPI-04 PET/CT demonstrated superior diagnostic performance, semi-quantitative capability, and N staging accuracy compared to [18F]FDG PET/CT, particularly for small metastatic lymph nodes (SAD < 10 mm), offering enhanced guidance for tumor staging.
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spelling doaj-art-a4a533a06b3e498e9c2c93afa87f3b2a2025-07-24T04:10:14ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16055681605568Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumorsWanjing ZhouJiashun DaiKai ZhengXiang PengYanyin ZhangChengzhi JiangJian YangHui YePurposeThis study compared the diagnostic performance, semi-quantitative capability, and staging accuracy of [18F]AlF-NOTA-FAPI-04 and [18F]FDG PET/CT in detecting lymph node metastases.MethodsThis single-center retrospective study included 41 patients with suspected lymph node metastases who received both [18F]FDG and [18F]AlF-NOTA-FAPI-04 PET/CT. The study compared metastatic lymph node detection, semi-quantitative values, and N staging accuracy. Subgroup analyses were performed for lymph nodes with short-axis diameters (SADs) ≥10 and <10 mm.ResultsA total of 41 patients with 126 nodes were included. [18F]AlF-NOTA-FAPI-04 outperformed [18F]FDG in the detection of metastatic lymph nodes, achieving higher accuracy in both patient-based (92.7% vs. 70.7%, p = 0.004) and node-based analyses (91.3% vs. 60.3%, p < 0.001). In semi-quantitative analysis, the maximum standardized uptake value and target-to-background ratio of [18F]AlF-NOTA-FAPI-04 were higher than those of [18F]FDG in metastatic lymph nodes (all p < 0.001). Both tracers distinguished metastatic from benign nodes with SAD ≥ 10 mm (p < 0.05). [18F]AlF-NOTA-FAPI-04 PET/CT could distinguish between benign and metastatic lymph nodes with SAD < 10 mm (p < 0.001), whereas [18F]FDG PET/CT could not (p > 0.05). [18F]AlF-NOTA-FAPI-04 also provided more accurate N staging assessments (87.8% vs. 65.9%, p = 0.006). [18F]AlF-NOTA-FAPI-04 PET/CT enabled the correct diagnosis of more lymph nodes, leading to a change in the therapeutic regimen for eight patients (19.5%).Conclusion[18F]AlF-NOTA-FAPI-04 PET/CT demonstrated superior diagnostic performance, semi-quantitative capability, and N staging accuracy compared to [18F]FDG PET/CT, particularly for small metastatic lymph nodes (SAD < 10 mm), offering enhanced guidance for tumor staging.https://www.frontiersin.org/articles/10.3389/fonc.2025.1605568/full[18F]AlF-NOTA-FAPI-04[18F]FDGPET/CTfibroblast activation protein (FAP)lymph node metastases
spellingShingle Wanjing Zhou
Jiashun Dai
Kai Zheng
Xiang Peng
Yanyin Zhang
Chengzhi Jiang
Jian Yang
Hui Ye
Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
Frontiers in Oncology
[18F]AlF-NOTA-FAPI-04
[18F]FDG
PET/CT
fibroblast activation protein (FAP)
lymph node metastases
title Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
title_full Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
title_fullStr Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
title_full_unstemmed Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
title_short Comparison of [18F]AlF-NOTA-FAPI-04 PET/CT and [18F]FDG PET/CT for diagnosing lymph node metastasis in malignant tumors
title_sort comparison of 18f alf nota fapi 04 pet ct and 18f fdg pet ct for diagnosing lymph node metastasis in malignant tumors
topic [18F]AlF-NOTA-FAPI-04
[18F]FDG
PET/CT
fibroblast activation protein (FAP)
lymph node metastases
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1605568/full
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