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Currently, clinical studies investigating\n                      <jats:sup>18<\/jats:sup>\n                      F-FAPI-RGD PET\/CT for CTD-ILD diagnosis are lacking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective study, CTD-ILD patients from the multidisciplinary clinic of Sichuan Provincial People\u2019s Hospital were enrolled. General clinical data and laboratory parameters were collected. All participants underwent multidisciplinary ILD diagnostic evaluation and completed\n                      <jats:sup>18<\/jats:sup>\n                      F-FAPI-RGD PET\/CT examinations to assess its clinical value in CTD-ILD diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study ultimately included 52 patients (35 CTD-ILD, 17 CTD). CTD-ILD patients showed significantly elevated serum IL-6 and KL-6 levels compared to CTD patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                      <jats:sup>18<\/jats:sup>\n                      F-FAPI-RGD PET\/CT imaging revealed significantly higher bilateral lung SUVmax (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lower spleen SUVmax (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) in CTD-ILD patients. Correlation analysis demonstrated significant positive association between bilateral lung SUVmax and CTD-ILD (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.62,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate logistic regression adjusted for age, KL-6, and DLCO% identified bilateral lung SUVmax (per 10-unit increase) as an independent predictor of CTD-ILD (OR\u2009=\u20091.459, 95% CI= [1.031\u20132.065],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033). Bilateral lung SUVmax exhibited excellent predictive value for ILD (AUC\u2009=\u20090.94, 95% CI= [0.88-1.00],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multiple linear regression showed KL-6 (\u03b2\u2009=\u20090.001, 95%CI [&lt;\u20090.001, 0.002],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) significantly positively influenced bilateral lung SUVmax, while DLCO% (\u03b2=-0.031 95%CI [-0.043, -0.020],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) exerted significant negative effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our findings demonstrate that\n                      <jats:sup>18<\/jats:sup>\n                      F-FAPI-RGD PET\/CT imaging is clinically applicable for CTD-ILD diagnosis. Future studies should explore its value in monitoring disease progression, treatment response assessment, and prognostic evaluation in CTD-ILD patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12931-025-03367-7","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T04:40:27Z","timestamp":1763181627000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pilot study of 18F-FAPI-RGD PET\/CT for the diagnosis of connective tissue disease associated interstitial lung disease"],"prefix":"10.1186","volume":"26","author":[{"given":"Hao","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wubin","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"3367_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.751181","volume":"8","author":"B Kaul","year":"2021","unstructured":"Kaul B, Cottin V, Collard HR, et al. 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Informed consent was obtained from all participating patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. All patient imaging data presented in this manuscript have been thoroughly anonymized to ensure that no individual can be identified.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"317"}}