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Evaluation of locoregional invasiveness of early lung adenocarcinoma manifesting as ground-glass nodules via [68Ga]Ga-FAPI-46 PET/CT imaging

  • 0Department of Nuclear Medicine and Minnan PET Center, Xiamen Key Laboratory of Radiopharmaceuticals, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, China.
European Journal of Nuclear Medicine and Molecular Imaging +

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May 24, 2025

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May 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

This study shows [68Ga]Ga-FAPI-46 PET/CT effectively differentiates early lung adenocarcinoma invasiveness. Maximum standardized uptake value (SUVmax) and radiomics features significantly improve diagnostic accuracy for ground-glass nodules.

Area Of Science

  • Oncology
  • Nuclear Medicine
  • Radiology

Background

  • Accurate histologic invasiveness differentiation is crucial for early lung adenocarcinoma surgical strategies.
  • Ground-glass nodules (GGNs) present a diagnostic challenge in early lung adenocarcinoma.
  • This study investigates [68Ga]Ga-FAPI-46 PET/CT for assessing GGN invasiveness.

Purpose Of The Study

  • To evaluate [68Ga]Ga-FAPI-46 PET/CT's potential in assessing invasiveness of early lung adenocarcinoma GGNs.
  • To identify imaging features predictive of invasiveness in GGNs.
  • To compare diagnostic performance with conventional and radiomics approaches.

Main Methods

  • Prospective study of 53 pulmonary GGNs (PGL-MIA and IAC) in 45 patients.
  • Nodule segmentation using MedSAM and PET Tumor Segmentation Extension.
  • Analysis of clinical, HRCT, and [68Ga]Ga-FAPI-46 PET radiomics features.
  • 5-fold cross-validation and external validation for machine learning models.

Main Results

  • [68Ga]Ga-FAPI-46 PET SUVmax independently predicted IAC (91% accuracy in training, 100% in test set).
  • Radiomics-based classification achieved 94% accuracy with an AUC of 0.97.
  • Key predictive feature: [68Ga]Ga-FAPI-46 PET log-sigma-7-mm-3D_firstorder_RootMeanSquared.

Conclusions

  • [68Ga]Ga-FAPI-46 PET/CT SUVmax effectively differentiates invasiveness in early lung adenocarcinoma GGNs.
  • Integrating high-throughput radiomics features enhances classification accuracy.
  • This imaging modality shows promise for guiding surgical decisions in early lung cancer.

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