Ma Yu, Liu Guanghui, Du Bulin, Li Xuefei, Li Yaming, Li Xuena
Department of Nuclear Medicine, The First Hospital of China Medical University, 155 Nanjing St, Shenyang, 110001, Liaoning, China.
Central Research Institute, United Imaging Healthcare, 2258 Chengbei Road, Shanghai, 201807, China.
Eur J Nucl Med Mol Imaging. 2025 Aug 7. doi: 10.1007/s00259-025-07495-6.
FAP-2286, which is a novel cyclic peptide that targets fibroblast activation protein (FAP), demonstrates enhanced plasma stability and improved receptor selectivity compared with small-molecule FAP inhibitors (FAPIs). Although [18 F]FAP-2286 exhibits benefits due to the favorable characteristics of fluorine-18-labeled tracers, its diagnostic performance in lung cancer remains to be fully elucidated. This study aimed to compare the diagnostic efficacy of [18 F]FAP-2286 PET/CT with that of [18 F]FDG PET/CT in lung cancer patients.
Thirty patients with suspected lung cancer (18 men and 12 women; median age: 64 years [IQR: 35-81]) underwent both [18 F]FAP-2286 and [18 F]FDG PET/CT for initial staging (n = 27) or the detection of recurrence (n = 3). Diagnostic performance was assessed using histopathology and clinical follow-up as reference standards. The quantitative analysis included the maximum standardized uptake value (SUV) and target-to-background ratio (TBR).
Compared with [18 F]FDG, [18 F]FAP-2286 PET/CT significantly increased the TBR in primary tumors (11.60 ± 6.02 vs. 5.80 ± 3.08; P < 0.001), whereas the SUV was not significantly different (15.20 ± 8.25 vs. 13.81 ± 7.73; P = 0.524). Although [18 F]FAP-2286 PET/CT demonstrated a lower detection rate for metastatic lymph nodes (67.46% [85/126] vs. 86.51% [109/126]; P < 0.001), it exhibited a higher true positive rate (95.29% vs. 68.81%; P < 0.001). For distant metastases, [18 F]FAP-2286 PET/CT demonstrated superior detection of bone (98.80% vs. 72.46%) and brain lesions (100% vs. 72.73%).
Compared with [18 F]FDG, [18 F]FAP-2286 PET/CT demonstrates superior performance for detecting bone metastases and provides more accurate N and M staging. These findings suggest that [18 F]FAP-2286 PET/CT may serve as a valuable alternative for the comprehensive evaluation of lung cancer patients.
FAP - 2286是一种靶向成纤维细胞活化蛋白（FAP）的新型环肽，与小分子FAP抑制剂（FAPI）相比，它具有更高的血浆稳定性和更好的受体选择性。尽管[18F]FAP - 2286由于氟 - 18标记示踪剂的良好特性而具有优势，但其在肺癌中的诊断性能仍有待充分阐明。本研究旨在比较[18F]FAP - 2286 PET/CT与[18F]FDG PET/CT在肺癌患者中的诊断效能。
30例疑似肺癌患者（18例男性和12例女性；中位年龄：64岁[四分位间距：35 - 81]）接受了[18F]FAP - 2286和[18F]FDG PET/CT检查，用于初始分期（n = 27）或复发检测（n = 3）。以组织病理学和临床随访作为参考标准评估诊断性能。定量分析包括最大标准化摄取值（SUV）和靶本比（TBR）。
与[18F]FDG相比，[18F]FAP - 2286 PET/CT显著提高了原发性肿瘤的TBR（11.60±6.02 vs. 5.80±3.08；P < 0.001），而SUV无显著差异（15.20±8.25 vs. 13.81±7.73；P = 0.524）。尽管[18F]FAP - 2286 PET/CT对转移淋巴结的检出率较低（67.46%[85/126] vs. 86.51%[109/126]；P < 0.001），但其真阳性率较高（95.29% vs. 68.81%；P < 0.001）。对于远处转移，[18F]FAP - 2286 PET/CT对骨转移（98.80% vs. 72.46%）和脑转移灶（100% vs. 72.73%）的检出表现更优。
与[18F]FDG相比，[18F]FAP - 2286 PET/CT在检测骨转移方面表现更优，并且能提供更准确的N和M分期。这些发现表明，[18F]FAP - 2286 PET/CT可能是肺癌患者综合评估的一种有价值的替代方法。
