Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression

Hiroshima, Takashi; Kimura, Toru; Watabe, Tadashi; Matsui, Takahiro; Omura, Akiisa; Sugiura, Yusuke; Nagata, Hideki; Kimura, Kenji; Fukui, Eriko; Kanou, Takashi; Ose, Naoko; Tatsumi, Mitsuaki; Giesel, Frederik L.; Morii, Eiichi; Shintani, Yasushi

doi:https://doi.org/10.1007/s10147-026-03047-6

Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression

Hiroshima, Takashi; Kimura, Toru; Watabe, Tadashi et al.

International Journal of Clinical Oncology, 2026, 31, 1336-1344

Number of Access:639（2026-09-29 08:33 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/105901

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Title	Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression
Creator	NRID 1000090966673 1000090966673 Scopus Author ID 57218528117 57218528117 CreatorName Hiroshima, Takashi
	NRID 1000090580796 1000090580796 ORCID 0000-0003-4504-232X 0000-0003-4504-232X researchmap permalink toru_kimura toru_kimura Scopus Author ID 7405706187 7405706187 CreatorName Kimura, Toru
	NRID 1000090648932 1000090648932 ORCID 0000-0001-8658-2395 0000-0001-8658-2395 researchmap permalink twosaka2018 twosaka2018 Scopus Author ID 57421862900 57421862900 CreatorName Watabe, Tadashi
	NRID 1000050747037 1000050747037 ORCID 0000-0002-6753-1688 0000-0002-6753-1688 researchmap permalink takahiromatsui takahiromatsui Scopus Author ID 35176152500 35176152500 CreatorName Matsui, Takahiro
	CreatorName Omura, Akiisa
	CreatorName Sugiura, Yusuke
	CreatorName Nagata, Hideki
	NRID 1000050795325 1000050795325 researchmap permalink kenkimurathoracic kenkimurathoracic CreatorName Kimura, Kenji
	NRID 1000090814591 1000090814591 ORCID 0000-0003-3800-1327 0000-0003-3800-1327 researchmap permalink ef90814591 ef90814591 Scopus Author ID 57205560883 57205560883 CreatorName Fukui, Eriko
	NRID 1000070528455 1000070528455 ORCID 0000-0003-2955-1490 0000-0003-2955-1490 researchmap permalink tkanou tkanou Scopus Author ID 55241221000 55241221000 CreatorName Kanou, Takashi
	NRID 1000010570559 1000010570559 researchmap permalink nose-1234 nose-1234 Scopus Author ID 24067435400 24067435400 CreatorName Ose, Naoko
	NRID 1000060397700 1000060397700 ORCID 0000-0003-1778-0421 0000-0003-1778-0421 researchmap permalink mtatsumi mtatsumi Scopus Author ID 7102266657 7102266657 CreatorName Tatsumi, Mitsuaki
	CreatorName Giesel, Frederik L.
	NRID 1000010283772 1000010283772 ORCID 0000-0001-8490-3650 0000-0001-8490-3650 researchmap permalink read0046454 read0046454 Scopus Author ID 7003914326 7003914326 CreatorName Morii, Eiichi
	NRID 1000090572983 1000090572983 ORCID 0000-0002-2540-5288 0000-0002-2540-5288 researchmap permalink shintani6384 shintani6384 Scopus Author ID 7103142734 7103142734 CreatorName Shintani, Yasushi
Subject	Cancer-associated fibroblasts
	Fibroblast activation protein
	Lung cancer
	Lymph node metastasis
	[¹⁸F]FAPI-74 PET
Description	Hiroshima T., Kimura T., Watabe T., et al. Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression. International Journal of Clinical Oncology 31, 1336–1344 (2026); https://doi.org/10.1007/s10147-026-03047-6.
Abstract	Background: Recent studies have demonstrated the utility of fibroblast activation protein inhibitor (FAPI)-positron emission tomography (PET) for cancer diagnosis. We investigated the diagnostic capability of [¹⁸F]FAPI-74 PET in patients with lung cancer eligible for surgery. Methods: This study included 30 patients (June 2022 to February 2024) who underwent [¹⁸F]FAPI-74 PET followed by lung resection at our institution and were pathologically diagnosed with primary lung cancer. The histological types included 24 adenocarcinomas, four squamous cell carcinomas, and two small cell carcinomas or combined small cell carcinomas and adenocarcinomas. Fibroblast activation protein (FAP) expression was evaluated in surgically resected specimens of primary tumors and lymph nodes using immunohistochemical staining. Results: All 30 primary lung lesions showed uptake on [¹⁸F]FAPI-74 PET (median maximum standardized uptake value [SUVmax] = 4.8; range: 1.2–15.5). A positive correlation was observed between the SUVmax of [¹⁸F]FAPI-74 PET and FAP expression by immunohistochemical staining (FAP-positive area, p = 0.0083; H-score, p = 0.0076). The sensitivity and specificity of [¹⁸F]FAPI-74 PET for the diagnosis of lymph node metastases were 75.0% and 88.5%, respectively. In all six cases of significant [¹⁸F]FAPI-74 uptake in lymph nodes, FAP expression was confirmed in the lymph node tissue by immunohistochemical staining. Three patients demonstrated lymph node uptake on [¹⁸F]FAPI-74 PET due to preoperative chemoradiation therapy or reactive lymph node enlargement/uptake without any malignant findings. Conclusions: In resectable early-stage lung cancer, [¹⁸F]FAPI-74 PET correlated with histological FAP expression and proved useful for detecting lymph node metastases, although caution is warranted when interpreting the findings after preoperative therapy.
Publisher	Springer
Source Title	International Journal of Clinical Oncology
Volume (Issue)	31
Page	1336-1344
Date of Issued	2026-06-02
Language	English
Handle URL	https://hdl.handle.net/11094/105901
PISSN	13419625
eISSN	14377772
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s10147-026-03047-6
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	International Journal of Clinical Oncology. 2026, 31, p. 1336-1344
DC.title	Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression
DC.creator	Hiroshima, Takashi
	Kimura, Toru
	Watabe, Tadashi
	Matsui, Takahiro
	Omura, Akiisa
	Sugiura, Yusuke
	Nagata, Hideki
	Kimura, Kenji
	Fukui, Eriko
	Kanou, Takashi
	Ose, Naoko
	Tatsumi, Mitsuaki
	Giesel, Frederik L.
	Morii, Eiichi
	Shintani, Yasushi
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2026-06-02
DC.identifier	https://doi.org/10.1007/s10147-026-03047-6
DC.subject	Cancer-associated fibroblasts
	Fibroblast activation protein
	Lung cancer
	Lymph node metastasis
	[¹⁸F]FAPI-74 PET
DC.description	Hiroshima T., Kimura T., Watabe T., et al. Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression. International Journal of Clinical Oncology 31, 1336–1344 (2026); https://doi.org/10.1007/s10147-026-03047-6.
DCTERMS.abstract	Background: Recent studies have demonstrated the utility of fibroblast activation protein inhibitor (FAPI)-positron emission tomography (PET) for cancer diagnosis. We investigated the diagnostic capability of [¹⁸F]FAPI-74 PET in patients with lung cancer eligible for surgery. Methods: This study included 30 patients (June 2022 to February 2024) who underwent [¹⁸F]FAPI-74 PET followed by lung resection at our institution and were pathologically diagnosed with primary lung cancer. The histological types included 24 adenocarcinomas, four squamous cell carcinomas, and two small cell carcinomas or combined small cell carcinomas and adenocarcinomas. Fibroblast activation protein (FAP) expression was evaluated in surgically resected specimens of primary tumors and lymph nodes using immunohistochemical staining. Results: All 30 primary lung lesions showed uptake on [¹⁸F]FAPI-74 PET (median maximum standardized uptake value [SUVmax] = 4.8; range: 1.2–15.5). A positive correlation was observed between the SUVmax of [¹⁸F]FAPI-74 PET and FAP expression by immunohistochemical staining (FAP-positive area, p = 0.0083; H-score, p = 0.0076). The sensitivity and specificity of [¹⁸F]FAPI-74 PET for the diagnosis of lymph node metastases were 75.0% and 88.5%, respectively. In all six cases of significant [¹⁸F]FAPI-74 uptake in lymph nodes, FAP expression was confirmed in the lymph node tissue by immunohistochemical staining. Three patients demonstrated lymph node uptake on [¹⁸F]FAPI-74 PET due to preoperative chemoradiation therapy or reactive lymph node enlargement/uptake without any malignant findings. Conclusions: In resectable early-stage lung cancer, [¹⁸F]FAPI-74 PET correlated with histological FAP expression and proved useful for detecting lymph node metastases, although caution is warranted when interpreting the findings after preoperative therapy.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	105901
citation_title	Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression
citation_author	Hiroshima, Takashi
	Kimura, Toru
	Watabe, Tadashi
	Matsui, Takahiro
	Omura, Akiisa
	Sugiura, Yusuke
	Nagata, Hideki
	Kimura, Kenji
	Fukui, Eriko
	Kanou, Takashi
	Ose, Naoko
	Tatsumi, Mitsuaki
	Giesel, Frederik L.
	Morii, Eiichi
	Shintani, Yasushi
citation_publisher	Springer
citation_language	English
citation_date	2026-06-02
citation_journal_title	International Journal of Clinical Oncology
citation_volume	31
citation_firstpage	1336
citation_lastpage	1344
citation_doi	https://doi.org/10.1007/s10147-026-03047-6
citation_public_url	https://hdl.handle.net/11094/105901

Fibroblast activation protein inhibitor-PET/CT in lung cancer: a prospective single-center study with histopathological correlation of fibroblast activation protein expression

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