Prospective Comparison of [18F]FDG and [18F]AIF-FAPI-74 PET/CT in the Evaluation of Potentially Resectable Pancreatic Ductal Adenocarcinoma
Bibliographic record
Abstract
Abstract Purpose Accurate clinical staging of potentially resectable pancreatic ductal adenocarcinoma (PDAC) is critical for establishing optimal treatment strategies. While the efficacy of fluorine-18-fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) in clinical staging is unclear, PET/CT detecting fibroblast-activation protein (FAP) expression has recently received considerable attention for detecting various tumors, including PDAC, with high sensitivity. We explored the efficacy of [ 18 F]FDG and [ 18 F]AIF-FAPI-74 PET/CT in the initial evaluation of potentially resectable PDAC. Procedures Between 2021 and 2022, twenty participants with newly diagnosed potentially resectable PDAC were enrolled. After the initial evaluation with pancreatic CT, [ 18 F]FDG PET/CT, and [ 18 F]AIF-FAPI-74 PET/CT, treatment strategies were determined considering the participant’s general status, clinical staging, and resectability. Pathological information from the surgical specimens was only available in 17 participants who underwent curative-intent surgery. Head-to-head comparisons of quantitative radiotracer uptake and diagnostic performance were performed among imaging modalities. Results [ 18 F]AIF-FAPI-74 PET/CT showed a significantly higher maximum standardized uptake value than [ 18 F]FDG PET/CT did in evaluating primary pancreatic lesions (median [interquartile range]; 12.6 [10.7–13.7] vs. 6.3 [4.8–9.2]; P < 0.001). In contrast, [ 18 F]AIF-FAPI-74 PET/CT showed a significantly lower mean standardized uptake value than [ 18 F]FDG PET/CT did in evaluating background organ (median [interquartile range]) 0.8 [0.7–0.9] vs. 2.6 [2.3–2.7]; P < 0.001). In addition, the sensitivity of [ 18 F]AIF-FAPI-74 PET/CT in detecting metastatic lymph nodes was higher than that of [ 18 F]FDG PET/CT (50.0% vs. 0.0%; P = 0.026). Conclusion This study demonstrated that [ 18 F]AIF-FAPI-74 PET/CT could improve the clinical staging of potentially resectable PDAC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".