{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:34:11Z","timestamp":1786120451621,"version":"build-2736575974"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":66,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Imaging"],"DOI":"10.1186\/s40644-026-01055-3","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T16:36:57Z","timestamp":1780418217000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["[18F]AlF-NOTA-FAPI-04 PET\/CT outperforms contrast-enhanced CT and contrast-enhanced MRI in clinical staging evaluation of patients with initial pancreatic cancer"],"prefix":"10.1186","volume":"26","author":[{"given":"Lili","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuye","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guolin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhui","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"1055_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.canlet.2021.06.027","volume":"520","author":"J Cai","year":"2021","unstructured":"Cai J, Chen H, Lu M, Zhang Y, Lu B, You L, Zhang T, Dai M, Zhao Y. Advances in the epidemiology of\u2002pancreatic\u2002cancer: Trends, risk factors, screening, and prognosis. Cancer Lett. 2021;520:1\u201311.","journal-title":"Cancer Lett"},{"issue":"4","key":"1055_CR2","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.7150\/thno.69475","volume":"12","author":"L Zhao","year":"2022","unstructured":"Zhao L, Chen J, Pang Y, Fu K, Shang Q, Wu H, Sun L, Lin Q, Chen H. Fibroblast\u2002activation\u2002protein-based theranostics in\u2002cancer\u2002research: A state-of-. the-art Rev Theranostics. 2022;12(4):1557\u201369.","journal-title":"the-art Rev Theranostics"},{"issue":"12","key":"1055_CR3","doi-asserted-by":"publisher","first-page":"1806","DOI":"10.2967\/jnumed.120.242958","volume":"61","author":"J Toms","year":"2020","unstructured":"Toms J, Kogler J, Maschauer S, Daniel C, Schmidkonz C, Kuwert T, Prante O. Targeting fbroblast activation protein: radiosynthesis and preclinical evaluation of an 18F-labeled FAP inhibitor. J Nucl Med. 2020;61(12):1806\u201313.","journal-title":"J Nucl Med"},{"issue":"7","key":"1055_CR4","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.2967\/jnumed.123.266981","volume":"65","author":"M Watanabe","year":"2024","unstructured":"Watanabe M, Fendler WP, Grafe H, Hirmas N, Hamacher R, Lanzafame H, Pabst KM, Hautzel H, Aigner C, Kasper S, von Tresckow B, Stuschke M, K\u00fcmmel S, Lugnier C, Hadaschik B, Gr\u00fcnwald V, Zarrad F, Siveke JT, Herrmann K, Weber M. Prognostic Implications of (68)Ga-FAPI-46\u2002PET\/CT- Derived Parameters on Overall Survival in Various Types of Solid Tumors. J Nucl Med. 2024;65(7):1027\u201334.","journal-title":"J Nucl Med"},{"issue":"1","key":"1055_CR5","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1148\/radiol.212884","volume":"303","author":"FL Jacobson","year":"2022","unstructured":"Jacobson FL, Van den Abbeele AD. Importance of (68)Ga-FAPI\u2002PET\/CT\u2002for Detection of Cancer. Radiology. 2022;303(1):200\u20131.","journal-title":"Radiology"},{"issue":"2","key":"1055_CR6","doi-asserted-by":"publisher","first-page":"206","DOI":"10.2967\/jnumed.123.266283","volume":"65","author":"X Li","year":"2024","unstructured":"Li X, Lu N, Lin L, Chen Y, Yang S, Wang H, Liu X, Wu C, Xue X, Su X, Bai X, Liang T. 18F-FAPI-04 Outperforms\u200218F-FDG PET\/CT in Clinical Assessments of Patients with Pancreatic Adenocarcinoma. J Nucl Med. 2024;65(2):206\u201312.","journal-title":"J Nucl Med"},{"issue":"6","key":"1055_CR7","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.1007\/s00259-025-07084-7","volume":"52","author":"Y Zhang","year":"2025","unstructured":"Zhang Y, Xu M, Wang Y, Yu F, Chen X, Wang G, Zhao K, Yang H, Su X. Value of [18F]AlF-NOTA-FAPI-04 PET\/CT for predicting pathological response and survival in patients with locally advanced pancreatic ductal adenocarcinoma receiving neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2025;52(6):2118\u201331.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"18","key":"1055_CR8","doi-asserted-by":"publisher","first-page":"6935","DOI":"10.7150\/thno.103399","volume":"14","author":"D Ruan","year":"2024","unstructured":"Ruan D, Sun J, Han C, Cai J, Yu L, Zhao L, Pang Y, Zuo C, Sun L, Wang Z, Tan G, Qu X, Chen H. (68)Ga-FAPI-46\u2002PET\/CT\u2002in the evaluation of gliomas: comparison with (18)F-FDG\u2002PET\/CT\u2002and\u2002contrast-enhanced\u2002MRI. Theranostics. 2024;14(18):6935\u201346.","journal-title":"Theranostics"},{"issue":"5","key":"1055_CR9","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1007\/s00259-020-05095-0","volume":"48","author":"W Guo","year":"2021","unstructured":"Guo W, Pang Y, Yao L, Zhao L, Fan C, Ke J, Guo P, Hao B, Fu H, Xie C, Lin Q, Wu H, Sun L, Chen H. Imaging\u2002fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [(68)Ga]Ga-FAPI- -04\u2002PET\/CT\u2002versus\u2002MRI\u2002and [(18)F]-FDG\u2002PET\/CT. Eur J Nucl Med Mol Ima- -ging. 2021;48(5):1604\u201317.","journal-title":"Eur J Nucl Med Mol Ima- -ging"},{"key":"1055_CR10","doi-asserted-by":"publisher","first-page":"649148","DOI":"10.3389\/fonc.2021.649148","volume":"11","author":"X Jiang","year":"2021","unstructured":"Jiang X, Wang X, Shen T, Yao Y, Chen M, Li Z, Li X, Shen J, Kou Y, Chen S, Zhou X, Luo Z, Cheng Z. FAPI-04 PET\/CT Using [18F]AlF Labeling Strategy: Automatic Synthesis, Quality Control, and\u2002In Vivo\u2002Assessment in Patient. Front Oncol. 2021;11:649148.","journal-title":"Front Oncol"},{"issue":"12","key":"1055_CR11","doi-asserted-by":"publisher","first-page":"4025","DOI":"10.1007\/s00259-022-05836-3","volume":"49","author":"L Ge","year":"2022","unstructured":"Ge L, Fu Z, Wei Y, Shi D, Geng Y, Fan H, Zhang R, Zhang Y, Li S, Wang S, Shi H, Song G, Pan J, Cheng K, Wang L. Preclinical evaluation and pilot clinical study of [18F]AlF-NOTA-FAPI-04\u2002for PET imaging of rheumatoid arthritis. Eur J Nucl Med Mol Imaging. 2022;49(12):4025\u201336.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"1055_CR12","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1245\/s10434-017-5810-x","volume":"24","author":"SK Kamarajah","year":"2017","unstructured":"Kamarajah SK, Burns WR, Frankel TL, Cho CS, Nathan H. Validation of the American Joint Commission on Cancer (AJCC) 8th ed. staging system for patients with pancreatic adenocarcinoma: A Surveillance, Epidemiology and End Results (SEER) analysis. Ann Surg Oncol. 2017;24:2023\u201330.","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"1055_CR13","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1148\/radiol.220329","volume":"306","author":"Y Bian","year":"2023","unstructured":"Bian Y, Zheng Z, Fang X, Jiang H, Zhu M, Yu J, Zhao H, Zhang L, Yao J, Lu L, Lu J, Shao C. Artificial Intelligence to Predict Lymph Node Metastasis at CT in Pancreatic Ductal Adenocarcinoma. Radiology. 2023;306(1):160\u20139.","journal-title":"Radiology"},{"key":"1055_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ejrad.2019.04.007","volume":"116","author":"JH Lee","year":"2019","unstructured":"Lee JH, Han SS, Hong EK, Cho HJ, Joo J, Park EY, Woo SM, Kim TH, Lee WJ. Park SJ.Predicting lymph node metastasis in pancreatobiliary cancer with magnetic resonance imaging: A prospective analysis. Eur J Radiol. 2019;116:1\u20137.","journal-title":"Eur J Radiol"},{"key":"1055_CR15","doi-asserted-by":"publisher","first-page":"790462","DOI":"10.3389\/fonc.2021.790462","volume":"11","author":"Z Zhang","year":"2022","unstructured":"Zhang Z, Zhou N, Guo X, Li N, Zhu H, Yang Z. Pretherapeutic Assessment of Pancreatic Cancer: Comparison of FDG PET\/CT Plus Delayed PET\/MR and Contrast-Enhanced CT\/MR. Front Oncol. 2022;11:790462.","journal-title":"Front Oncol"},{"issue":"1","key":"1055_CR16","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1148\/radiol.2016152798","volume":"282","author":"I Joo","year":"2017","unstructured":"Joo I, Lee JM, Lee DH, Lee ES, Paeng JC, Lee SJ, Jang JY, Kim SW, Ryu JK, Lee KB. Preoperative Assessment of Pancreatic Cancer with FDG PET\/MR Imaging versus FDG PET\/CT Plus Contrast-enhanced Multidetector CT: A Prospective Preliminary Study. Radiology. 2017;282(1):149\u201359.","journal-title":"Radiology"},{"key":"1055_CR17","doi-asserted-by":"crossref","unstructured":"Wood LD, Canto MI, Jaffee EM, Simeone DM, Pancreatic\u2002cancer: pathogenesis, screening. diagnosis, and treatment. Gastroenterology. 2022;163(2):386\u2013402.e1.","DOI":"10.1053\/j.gastro.2022.03.056"},{"issue":"11","key":"1055_CR18","doi-asserted-by":"publisher","first-page":"2484","DOI":"10.1007\/s11605-023-05850-2","volume":"27","author":"M Lee","year":"2023","unstructured":"Lee M, Thomas AS, Lee SY, Cho YJ, Jung HS, Yun WG, Han Y, Jang JY, Kluger MD, Kwon W. Reconsidering the absence of extrapancreatic extension in\u2002T\u2002staging\u2002for\u2002pancreatic\u2002adenocarcinoma in the AJCC (8(th) ed)\u2002Staging Manual using the National\u2002Cancer\u2002Database. J Gastrointest Surg. 2023;27(11):2484\u201392.","journal-title":"J Gastrointest Surg"},{"key":"1055_CR19","doi-asserted-by":"publisher","first-page":"101909","DOI":"10.1016\/j.suronc.2023.101909","volume":"47","author":"TL de Jong","year":"2023","unstructured":"de Jong TL, Koopman D, van der Worp CAJ, Stevens H, Vuijk FA, Vahrmeijer AL, Mieog JSD, de Groot JB, Meijssen MAC, Nieuwenhuijs VB, de Geus-Oei LF, Jager PL, Patijn GA. Added value of digital FDG-PET\/CT in disease\u2002stagin- -g\u2002and restaging in patients with\u2002resectable\u2002or\u2002borderline\u2002resecta ble\u2002pancreat- -ic\u2002cancer. Surg Oncol. 2023;47:101909.","journal-title":"Surg Oncol"},{"issue":"6","key":"1055_CR20","doi-asserted-by":"publisher","first-page":"779","DOI":"10.2967\/jnumed.120.253062","volume":"62","author":"M R\u00f6hrich","year":"2021","unstructured":"R\u00f6hrich M, Naumann P, Giesel FL, Choyke PL, Staudinger F, Wefers A, Liew DP, Kratochwil C, Rathke H, Liermann J, Herfarth K, J\u00e4ger D, Debus J, Haberkorn U, Lang M, Koerber SA. Impact of\u200268Ga-FAPI PET\/CT Imaging on the Therapeutic Management of Primary and Recurrent Pancreatic Ductal Adenocarcinomas. J Nucl Med. 2021;62(6):779\u201386.","journal-title":"J Nucl Med"},{"issue":"8","key":"1055_CR21","doi-asserted-by":"publisher","first-page":"840","DOI":"10.3748\/wjg.v18.i8.840","volume":"18","author":"M Shi","year":"2012","unstructured":"Shi M, Yu DH, Chen Y, Zhao CY, Zhang J, Liu QH, Ni CR, Zhu MH. Expression of fibroblast activation protein in human pancreatic adenocarcinoma and its clinicopathological significance. World J Gastroenterol. 2012;18(8):840\u20136.","journal-title":"World J Gastroenterol"},{"issue":"1","key":"1055_CR22","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s40644-023-00596-1","volume":"23","author":"Z Lyu","year":"2023","unstructured":"Lyu Z, Han W, Zhang Q, Zhao H, Liu S, Wang Y, He J, Zhao C, Tian L, Fu P. Clinical application of Al18F-NOTA-FAPI PET\/CT in diagnosis and TNM staging of pancreatic adenocarcinoma, compared to 18F-FDG. Cancer Imaging. 2023;23(1):86.","journal-title":"Cancer Imaging"},{"key":"1055_CR23","doi-asserted-by":"crossref","unstructured":"Bilimoria KY, Bentrem DJ, Ko CY, Ritchey J, Stewart AK, Winchester DP, Talamonti MS. Validation of the 6th edition AJCC Pancreatic Cancer Staging System: report from the National Cancer Database. Cancer. 2007;110(4):738\u201344.","DOI":"10.1002\/cncr.22852"},{"issue":"5","key":"1055_CR24","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.surg.2006.12.013","volume":"141","author":"TM Pawlik","year":"2007","unstructured":"Pawlik TM, Gleisner AL, Cameron JL, Winter JM, Assumpcao L, Lillemoe KD, Wolfgang C, Hruban RH, Schulick RD, Yeo CJ, Choti MA. Prognostic relevance of lymph node ratio following pancreaticoduodenectomy for pancreatic cancer. Surgery. 2007;141(5):610\u20138.","journal-title":"Surgery"},{"issue":"1","key":"1055_CR25","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13244-020-00861-y","volume":"11","author":"KY Elbanna","year":"2020","unstructured":"Elbanna KY, Jang HJ, Kim TK. Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review. Insights Imaging. 2020;11(1):58.","journal-title":"Insights Imaging"},{"issue":"1","key":"1055_CR26","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/MPA.0b013e3182550d77","volume":"42","author":"A Asagi","year":"2013","unstructured":"Asagi A, Ohta K, Nasu J, Tanada M, Nadano S, Nishimura R, Teramoto N, Yamamoto K, Inoue T, Iguchi H. Utility of contrast-enhanced FDG-PET\/CT in the clinical management of\u2002pancreatic\u2002cancer: impact on diagnosis, staging, evaluation of treatment response, and detection of recurrence. Pancreas. 2013;42(1):11\u20139.","journal-title":"Pancreas"},{"issue":"2","key":"1055_CR27","doi-asserted-by":"publisher","first-page":"329","DOI":"10.21037\/jgo.2020.03.06","volume":"11","author":"Y Deng","year":"2020","unstructured":"Deng Y, Ming B, Wu JL, Zhou T, Zhang SY, Chen Y, Lan C, Zhang XM. Magnetic resonance imaging for preoperative staging of pancreatic cancer based on the 8th\u2002edition of AJCC guidelines. J Gastrointest Oncol. 2020;11(2):329\u201336.","journal-title":"J Gastrointest Oncol"},{"issue":"11","key":"1055_CR28","doi-asserted-by":"publisher","first-page":"8146","DOI":"10.3390\/curroncol29110643","volume":"29","author":"W Li","year":"2022","unstructured":"Li W, Wang W, Yao L, Tang Z, Zhai L. Nomogram for Predicting Distant Metastasis of Pancreatic Ductal Adenocarcinoma: A SEER-Based Population Study. Curr Oncol. 2022;29(11):8146\u201359.","journal-title":"Curr Oncol"},{"key":"1055_CR29","doi-asserted-by":"crossref","unstructured":"Lin L, Wang G, Zhang Y, Wang G, Zhao K, Su X. Clinical utility of\u200218Fluorine- fibroblast activation protein inhibitor-04 positron emission tomography\/ computed tomography in the evaluation of pancreatic ductal adenocarcinoma: comparison with\u200218Fluorine-fluorodeoxyglucose positron emission tomography\/computed tomography. MedComm (2020). 2025; 6(3):e70136.","DOI":"10.1002\/mco2.70136"},{"issue":"12","key":"1055_CR30","doi-asserted-by":"publisher","first-page":"10279","DOI":"10.1007\/s00432-023-04903-y","volume":"149","author":"Q Yao","year":"2023","unstructured":"Yao Q, Jia W, Chen S, Wang Q, Liu Z, Liu D, Ji X. Machine learning was used to predict risk factors for distant metastasis of pancreatic cancer and prognosis analysis. J Cancer Res Clin Oncol. 2023;149(12):10279\u201391.","journal-title":"J Cancer Res Clin Oncol"},{"key":"1055_CR31","doi-asserted-by":"crossref","unstructured":"Huang J, Li X, Jiang Q, Qiu H, Rong Y, Cui B, et al. Analysis of risk factors for distant metastasis of pancreatic ductal adenocarcinoma without regional lymph node metastasis and a nomogram prediction model for survival. Evid Based Complement Alternat Med. 2023;2023:2916974.","DOI":"10.1155\/2023\/2916974"}],"container-title":["Cancer Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40644-026-01055-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40644-026-01055-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40644-026-01055-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T23:04:06Z","timestamp":1786057446000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40644-026-01055-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1055"],"URL":"https:\/\/doi.org\/10.1186\/s40644-026-01055-3","relation":{},"ISSN":["1470-7330"],"issn-type":[{"value":"1470-7330","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"assertion":[{"value":"18 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This clinical study was approved by the institute\u2019s ethics committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Clinical Trials.gov. ID NCT05884463). All recruited patients signed a written informed consent form.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent has been obtained from the patients to publish this study.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"100"}}