{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:02:45Z","timestamp":1782889365476,"version":"3.54.5"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Science and Technology Program of Guangzhou","award":["2024A03J1160"],"award-info":[{"award-number":["2024A03J1160"]}]},{"name":"the Science and Technology Program of Guangzhou","award":["202201020558"],"award-info":[{"award-number":["202201020558"]}]},{"name":"the Science and Technology Program of Guangzhou","award":["202102010252"],"award-info":[{"award-number":["202102010252"]}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["(No. 82001879"],"award-info":[{"award-number":["(No. 82001879"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Guangdong Medical Science and Technology Research Funding","award":["A2023233"],"award-info":[{"award-number":["A2023233"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This study investigates the value of fluorine 18 ([<jats:sup>18<\/jats:sup>F])-labeled fibroblast activation protein inhibitor (FAPI) for lymph node (LN) metastases in patients with stage I-IIIA non-small cell lung cancer (NSCLC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>From November 2021 to October 2022, 53 patients with stage I-IIIA NSCLC who underwent radical resection were prospectively included. [<jats:sup>18<\/jats:sup>F]-fluorodeoxyglucose (FDG) and [<jats:sup>18<\/jats:sup>F]FAPI examinations were performed within one week. LN staging was validated using surgical and pathological findings. [<jats:sup>18<\/jats:sup>F]FDG and [<jats:sup>18<\/jats:sup>F]FAPI uptake was compared using the Wilcoxon signed-ranks test. Furthermore, the diagnostic value of nodal groups was investigated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In 53 patients (median age, 64 years, range: 31\u201376 years), the specificity of [<jats:sup>18<\/jats:sup>F]FAPI for detecting LN metastasis was significantly higher than that of [<jats:sup>18<\/jats:sup>F]FDG (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). High LN risk category, greater LN short-axis dimension(\u2265\u20091.0\u00a0cm), absence of LN calcification or high-attenuation, and higher LN FDG SUV<jats:sub>max<\/jats:sub> (\u2265\u200910.1) were risk factors for LN metastasis(<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The concurrence of these four risk factors accurately predicted LN metastases (Positive Predictive Value [PPV] 100%), whereas the presence of one to three risk factors was unable to accurately discriminate the nature of LNs (PPV 21.7%). Adding [<jats:sup>18<\/jats:sup>F]FAPI in this circumstance improved the diagnostic value. LNs with an [<jats:sup>18<\/jats:sup>F]FAPI SUV<jats:sub>max<\/jats:sub>&lt;6.2 were diagnosed as benign (Negative Predictive Value 93.8%), and LNs with an [<jats:sup>18<\/jats:sup>F]FAPI SUV<jats:sub>max<\/jats:sub>\u22656.2 without calcification or high-attenuation were diagnosed as LN metastasis (PPV 87.5%). Ultimately, the integration of [<jats:sup>18<\/jats:sup>F]FDG and [<jats:sup>18<\/jats:sup>F]FAPI PET\/CT resulted in the highest accuracy for N stage (83.0%) and clinical decision revisions for 29 patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In patients with stage I-IIIA NSCLC, [<jats:sup>18<\/jats:sup>F]FAPI contributed additional valuable information to reduce LN diagnostic uncertainties after [<jats:sup>18<\/jats:sup>F]FDG PET\/CT. Integrating [<jats:sup>18<\/jats:sup>F]FDG and [<jats:sup>18<\/jats:sup>F]FAPI PET\/CT resulted in more precise clinical decisions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The Chinese Clinical Trial Registry: ChiCTR2100044944 (Registered: 1 April 2021, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showprojEN.html?proj=123995\">https:\/\/www.chictr.org.cn\/showprojEN.html?proj=123995<\/jats:ext-link><jats:italic>).<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40644-024-00701-y","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T08:09:09Z","timestamp":1717402149000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["[18F]FAPI adds value to [18F]FDG PET\/CT for diagnosing lymph node metastases in stage I-IIIA non-small cell lung cancer: a prospective study"],"prefix":"10.1186","volume":"24","author":[{"given":"Youcai","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihua","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqiang","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxing","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-5687","authenticated-orcid":false,"given":"Xinlu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"701_CR1","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1148\/radiol.2016152234","volume":"281","author":"Y Huang","year":"2016","unstructured":"Huang Y, Liu Z, He L, et al. 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This single-center prospective study was approved by the Clinical Research Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University and the Chinese Clinical Trial Registry (ChiCTR2100044944).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent to publish has been received from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"was obtained from all participants enrolled in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"68"}}