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Gross tumor volume (GTV), clinical tumor volume (CTV), and planning tumor volume (PTV) were drawn for the primary tumor (GTVp) and involved lymph nodes (GTVnd) based on CE-CT, [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT. Organs at risk were evaluated and compared in intensity-modulated radiation therapy (IMRT) and intensity-modulated proton therapy (IMPT) plans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-one patients (median age, 64 years; 38 males [74.5%]) were evaluated. Statistically significant differences in GTVs based on CE-CT, [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT, and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT were found between each pair (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), except that no difference in GTVp was found between [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT (\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.558). CE-CT-based GTVp values were significantly larger than those based on [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT and [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT due to the presence of obstructive pneumonia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). PTVall-IMRT based on CE-CT (351.98\u2009\u00b1\u200926.87) was significantly larger than that based on [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT (329.98\u2009\u00b1\u200926.21;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03). PTVall-IMPT based on CE-CT (212.74\u2009\u00b1\u200918.73) was significantly larger than those based on [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT (204.26\u2009\u00b1\u200919.34) and [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT (196.99\u2009\u00b1\u200918.38), with\n                      <jats:italic>P<\/jats:italic>\n                      -values of 0.046 and 0.011, respectively. For IMRT, [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT-based plans significantly reduced the radiation doses received by the heart, contralateral lung, and both lungs (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      [\n                      <jats:sup>18<\/jats:sup>\n                      F]AlF-NOTA-FAPI PET\/CT shows promise as a valuable tool for radiotherapy planning in lung cancer, providing accurate target delineation and improved sparing of critical organs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This study was approved by the Clinical Research Ethics Committee of our institution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07753-7","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:49:37Z","timestamp":1770252577000},"page":"3760-3774","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Value of [18F]AlF-NOTA-FAPI PET\/CT in guiding radiotherapy planning for stage I-IIIC lung cancer: A comparison with contrast-enhanced CT and [18F]FDG PET\/CT"],"prefix":"10.1007","volume":"53","author":[{"given":"Jingjie","family":"Qin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengqiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqin","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"San","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinming","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7198-9915","authenticated-orcid":false,"given":"Yuchun","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"Suppl 2","key":"7753_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/resp.13870","volume":"25","author":"SK Vinod","year":"2020","unstructured":"Vinod SK, Hau E. 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