Article Figures & Data
Figures
- FIGURE 1.
FAP expression in lepidic LC. (A and B) Representative hematoxylin and eosin staining (left) and immunohistochemical staining against FAP (right) of central part of lepidic LC biopsy, which shows strong stromal FAP positivity (A), and tumor front of lepidic LC, showing transition from FAP-positive LC tumor rim into FAP-negative physiologic lung tissue (B) (magnification: upper rows, ×10; lower rows, ×40) (scale bars: upper rows, 100 μm; lower rows, 20 μm).
- FIGURE 2.
Quantitative analysis of 18F-FDG and 68Ga-FAPI-46 uptake in LC and benign pulmonary lesions of 19 patients. (A–C) Box plots of SUVmax, SUVmean, and their corresponding TBRs against mediastinal blood pool for LC and benign pulmonary lesions calculated for 18F-FDG (A) and 68Ga-FAPI-46 (B) and fold changes of all parameters calculated for ratio of 68Ga-FAPI-46 to18F-FDG (C). Boxes represent interquartile range, whiskers represent interquartile range of 1.5, and horizontal line within box indicates median. Data outliers are shown separately within graph. *P < 0.05. **P < 0.01. ns = not significant.
- FIGURE 3.
Example 18F-FDG and 68Ga-FAPI-46 images of 51-y-old woman with adenocarcinoma with lepidic growth pattern in right upper lobe. (A) Maximum-intensity-projection PET images. (B) Axial images of suggestive lesion (red arrows) with low CT density in right lower lobe. Green arrows show blood pool in aortic arch. Lesion had 18F-FDG uptake below blood pool niveau but was strongly 68Ga-FAPI-46–positive. CT-guided biopsy led to pathologic diagnosis of adenocarcinoma, and patient was treated by stereotactic body radiation therapy because of functional inoperability. HU = Hounsfield units.
- FIGURE 4.
Example 18F-FDG and 68Ga-FAPI-46 images of 41-y-old man with hamartoma in left lower lobe. (A) Maximum-intensity-projection PET images. (B) Axial images of suggestive lesion (arrows) in left lower lobe. After wedge resection, hamartoma was diagnosed by pathology. HU = Hounsfield units.
- FIGURE 5.
Dynamic 68Ga-FAPI-46 PET imaging properties of LC and benign pulmonary lesions. (A) Averaged time–activity curves (relative to peak) of LC and benign pulmonary lesions. (B) Box plot of time to peak and slope of LC and benign pulmonary lesions. Boxes represent interquartile range, whiskers represent interquartile range of 1.5, and horizontal line within box indicates median. (C) Representative cases: 63-y-old man with adenocarcinoma (arrow) of left upper lobe and 62-y-old man with focally 68Ga-FAPI-46–avid sarcoid mass (encircled) in right lower lobe. Images are from static PET, and time–activity curves are from dynamic PET. Although both lesions show intermediate 68Ga-FAPI-46 uptake, time–activity curves clearly differ, with delayed peak of LC and markedly pronounced slope of sarcoidosis. *P < 0.05.
- FIGURE 6.
Receiver-operating-characteristic (ROC) curves of 4 quantitative PET parameters with highest discriminatory power: 68Ga-FAPI-46/18F-FDG SUVmax (A), 68Ga-FAPI-46/18F-FDG TBR SUVmax (B), SUVmean TBR (C), and SUVmax TBR (D).
Tables
- TABLE 1.
Clinical Parameters and Diagnoses of 19 Patients with 18F-FDG–Negative Pulmonary Lesions
Patient no. Age (y) Sex Dynamic PET imaging Localization Largest diameter (mm) Histologic confirmation Diagnosis Growth pattern TNM stage 1 64 M No Right upper lobe 20 Wedge resection Tuberculosis Not applicable Not applicable 2 73 M Yes Left hilus 14 Bronchoscopy with biopsy Calcified lymph node Not applicable Not applicable 3 68 F Yes Right lower lobe 29 Lobectomy Adenocarcinoma Lepidic T1cN0M0 4 58 M Yes Right upper lobe 10 Wedge resection Granuloma Not applicable Not applicable 5 75 M Yes Left lower lobe 16 Lobectomy Adenocarcinoma Acinar/lepidic T1bN0M0 6 70 F Yes Left lower lobe 23 Lobectomy Adenocarcinoma Acinar T1cN0M0 7 62 M Yes Right lower lobe 79 Lobectomy Sarcoidosis Not applicable Not applicable 8 50 M Yes Left upper lobe 13 CT-guided biopsy Adenocarcinoma Acinar T1bN0M0 9 57 F Yes Right lower lobe 17 Lobectomy Adenocarcinoma Acinar T1cN0M0 10 63 M Yes Right upper lobe 15 CT-guided biopsy Adenocarcinoma Acinar T1bN1M0 11 41 M No Left lower lobe 17 Wedge resection Hamartoma Not applicable Not applicable 12 45 M Yes Right lower lobe 16 Enucleation Hamartoma Not applicable Not applicable 13 70 M Yes Right upper lobe 16 Lobectomy Adenocarcinoma Acinar T2aN0M0 14 72 M Yes Left upper lobe 23 Lobectomy Adenocarcinoma Acinar T1bN0M0 15 65 M Yes Right upper lobe 29 Lobectomy Adenocarcinoma Lepidic T1cN0M0 16 50 M No Right lower lobe 18 CT-guided biopsy Typical carcinoid Not applicable T1bN0M0 17 51 F Yes Right upper lobe 29 CT-guided biopsy Adenocarcinoma Lepidic/acinar T2aN0M0 18 64 F Yes Left upper lobe 28 Segment resection Adenocarcinoma Lepidic T1aN0M0 19 77 M Yes Left lower lobe 15 CT-guided biopsy Lung tissue Not applicable Not applicable
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