TY  - JOUR
AU  - Wessendorf, Joel
AU  - Spektor, Anna-Maria
AU  - Aboulmaouahib, Brahim
AU  - Daum, Johanna
AU  - Glatting, Frederik M
AU  - Schlamp, Kai
AU  - Grott, Matthias
AU  - Eichhorn, Florian
AU  - Heußel, Claus Peter
AU  - Kauczor, Hans Ulrich
AU  - Kreuter, Michael
AU  - Schreckenberger, Mathias
AU  - Winter, Hauke
AU  - Haberkorn, Uwe
AU  - Röhrich, Manuel
TI  - Image analysis: 68Ga-FAPI-46 PET derived texture parameters improve the differentiation of malignant and benign pulmonary lesions.
JO  - Cancer imaging
VL  - 25
IS  - 1
SN  - 1470-7330
CY  - London
PB  - BioMed Central
M1  - DKFZ-2025-01208
SP  - 73
PY  - 2025
AB  - Pulmonary lesions inconclusive in 18F-FDG PET/CT are a known clinical problem. Both texture analysis and 68Ga-FAPI-46 have shown potential in thoracic oncological problems but their combination has not been assessed yet. This initial analysis aims to evaluate the utility of 68Ga-FAPI-46 PET texture parameters to differentiate between lung cancer and benign pulmonary lesions inconclusive in 18F-FDG PET/CT.20 histologically confirmed pulmonary lesions (13 lung cancer, 7 benign) in 19 patients were evaluated. All patients underwent an inconclusive 18F-FDG PET/CT before 68Ga-FAPI-46 PET/CT. 64 texture parameters and conventional parameters (SUVs, TBRs) were analyzed. Texture parameters with significant (P < 0.05) differences between lung cancer and benign lesions were detected by the Mann-Whitney U test. Boxplots and a scatter plot matrix were created. Principal component analyses and Spearman correlations were performed. Receiver operating characteristics curves with area under the curve (AUC) values were created for univariable and bivariable logistic regression.The texture parameters HIST Maximum grey level (AUC = 0.901), HIST Mean (AUC = 0.802), HIST Mode (AUC = 0.835), HIST Range (AUC = 0.901) and GLCM Information correlation 1 (AUC = 0.824) showed significant differences between lung cancer and benign pulmonary lesions. AUC values of conventional parameters (SUVmax, SUVmean, TBR(SUVmax), TBR(SUVmean)) were 0.791, 0.868, 0.802 and 0.857, respectively. Maximum AUC values of bivariable logistic regression were 0.967 and 0.978 for two texture parameters and the combination of conventional and texture parameters, respectively. Correlations between texture parameter pairs were mainly moderate (0.4≤ρ≤0.59). 2/5 texture parameters (HIST Mean, HIST Mode) displayed no very strong correlations (0.8≤ρ≤1.00) to any conventional parameters or lesion volume.68Ga-FAPI-46 PET texture parameters show great potential to differentiate between lung cancer and benign pulmonary lesions inconclusive in 18F-FDG/PET. Spearman correlations indicate additional information value of texture parameters.
KW  - Humans
KW  - Lung Neoplasms: diagnostic imaging
KW  - Lung Neoplasms: pathology
KW  - Female
KW  - Male
KW  - Middle Aged
KW  - Aged
KW  - Positron Emission Tomography Computed Tomography: methods
KW  - Diagnosis, Differential
KW  - Gallium Radioisotopes
KW  - Fluorodeoxyglucose F18
KW  - Radiopharmaceuticals
KW  - Aged, 80 and over
KW  - Adult
KW  - Image analysis (Other)
KW  - Lung cancer (Other)
KW  - Pulmonary lesion (Other)
KW  - Texture analysis (Other)
KW  - Gallium Radioisotopes (NLM Chemicals)
KW  - Fluorodeoxyglucose F18 (NLM Chemicals)
KW  - Radiopharmaceuticals (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:40506754
DO  - DOI:10.1186/s40644-025-00886-w
UR  - https://inrepo02.dkfz.de/record/302010
ER  -