{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:33:26Z","timestamp":1777358006410,"version":"3.51.4"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82203014, 81627901, 22307068, 82172676, 82030082, 8203000516"],"award-info":[{"award-number":["82203014, 81627901, 22307068, 82172676, 82030082, 8203000516"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Background<\/jats:title>\n \n Conventional imaging has limitations in differentiating benign from malignant breast lesions and in staging breast cancer (BC). This study compared the diagnostic and staging performance of [\n 18<\/jats:sup>\n F]AlF-NOTA-FAPI-04 PET\/CT with conventional imaging in suspected breast lesions.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This single-center\n post hoc<\/jats:italic>\n retrospective analysis included therapy-na\u00efve participants with suspected breast lesions who underwent [\n 18<\/jats:sup>\n F]AlF-NOTA-FAPI-04 PET\/CT between July 2023 and February 2025. All patients underwent ultrasonography, mammography, breast MRI, whole-body CT, and bone scan. Conventional imaging results were based on consensus visual interpretation integrating these modalities. PET\/CT images were assessed visually and semi-quantitatively to assess the diagnostic accuracy. Lesions were confirmed by histopathology and follow-up (median, 4.5 months). Diagnostic performance for primary breast lesions, regional lymph nodes metastases (LNM), and distant metastases was evaluated on lesion-based, whereas visual scoring and staging (the AJCC eighth edition) comparisons were patient-based. Receiver operating characteristic\/Delong and McNemar \u03c7\u00b2 analyses were performed using SPSS Statistics 29.0.\u00a0A two-sided\n P<\/jats:italic>\n \u00a0&lt;\u00a00.05 was statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sixty-nine women (median age, 50 years) with 81 breast lesions, 797 regional lymph nodes, and 94 distant metastases were included, and all 69 patients underwent ultrasonography, mammography, breast MRI, whole-body CT, and bone scan. For primary breast lesions, conventional imaging showed sensitivity and specificity of 93.75% and 100.00%, whereas visual PET\/CT showed 98.44% and 70.59%. Although LBR\n breast<\/jats:sub>\n achieved the highest area under the curve (AUC), its AUC was not significantly different from that of conventional imaging (1.000 vs. 0.970,\n P<\/jats:italic>\n \u00a0=\u00a00.078). In contrast, visual PET\/CT showed a significantly lower AUC than conventional imaging (0.845 vs. 0.970,\n P<\/jats:italic>\n \u00a0=\u00a00.034). For regional LNM detection, visual PET\/CT achieved sensitivity and specificity of 95.95% and 97.60%, which were significantly higher than the corresponding values of conventional imaging (73.99% and 95.41%, all\n P<\/jats:italic>\n \u00a0&lt;\u00a00.05). PET\/CT detected all 94 distant metastases, and patient-based visual scores favored PET\/CT over conventional imaging (52 vs. 34). PET\/CT also improved the accuracy in predicting pathological N staging (91.43% vs. 65.71%,\n P<\/jats:italic>\n \u00a0=\u00a00.008) and final staging (74.29% vs. 45.71%,\n P<\/jats:italic>\n \u00a0=\u00a00.009).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n [\n 18<\/jats:sup>\n F]AlF-NOTA-FAPI-04 PET\/CT outperforms conventional imaging in detecting regional LNM and improving pathological staging accuracy in BC.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2026.1795128","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:35:35Z","timestamp":1777354535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of [18F]AlF-NOTA-FAPI-04 PET\/CT in breast cancer: comparison with conventional imaging"],"prefix":"10.3389","volume":"16","author":[{"given":"Jingru","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oncology, Renmin 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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengnan","family":"Xu","sequence":"additional","affiliation":[{"name":"Center for Nuclear Medicine and Molecular Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinli","family":"Pei","sequence":"additional","affiliation":[{"name":"Center for Nuclear Medicine and Molecular Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shijie","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Nuclear Medicine and Molecular Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, 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Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanhu","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Nuclear Medicine and Molecular Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Nuclear Medicine and Molecular Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and 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