Per-Lesion Radiomics Analysis of 68Ga-DOTA FAPI-46 and 18F-FDG PET/CT in Non-Small Cell Lung Cancer: A pilot Study
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| Main Authors: | , , , , , , , , , , |
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| Format: | Preprint |
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2025
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| _version_ | 1866908647258324992 |
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| author | Hasanabadi, Setareh Cheraghi, Maryam Manesh, Hossein Behnam Bayat, Mohadeseh Karam, Mehrdad Bakhshayesh Corsi, Andrea Salimi, Yazdan Azimi, Mohammad Saber Doroudinia, Abtin Karami, Arezu Arabi, Hossein |
| author_facet | Hasanabadi, Setareh Cheraghi, Maryam Manesh, Hossein Behnam Bayat, Mohadeseh Karam, Mehrdad Bakhshayesh Corsi, Andrea Salimi, Yazdan Azimi, Mohammad Saber Doroudinia, Abtin Karami, Arezu Arabi, Hossein |
| contents | This pilot study compares per-lesion radiomics features of [68Ga]-DOTA FAPI-46 and [18F]-FDG PET/CT in non-small cell lung cancer (NSCLC) to explore complementary insights into intratumoral heterogeneity beyond conventional SUV metrics, aiming to enhance lesion characterization and clinical decision-making. A total of 28 PET/CT scans (14 [18F]-FDG and 14 [68Ga]-DOTA FAPI-46) were acquired for the initial staging of biopsy-confirmed NSCLC. A total of 81 co-localized lesions (lung: 21, mediastinal lymph nodes: 42, bone: 18) were segmented, with radiomics features extracted via PyRadiomics after IBSI-compliant preprocessing. Paired per-lesion comparisons used t-tests or Wilcoxon signed-rank tests with Benjamini-Hochberg FDR correction. Significant differences (adjusted P < 0.05) were identified across intensity, texture, and shape features. In lung lesions, FAPI showed lower first-order metrics but higher variance and GLCM contrast, suggesting stromal heterogeneity. Mediastinal lymph nodes had fewer differences, with FAPI exhibiting lower run percentage (GLRLM: -0.298, -6.196, P=1.45E-08). Bone lesions showed extensive variations, including reduced FAPI entropy (e.g., Entropy: -1.743, -5.798, P=6.95E-08). Feature overlaps highlighted complementary stromal (FAPI) and metabolic (FDG) insights. This pilot study demonstrates that per-lesion radiomics can capture complementary biological information from FAPI and FDG PET in NSCLC, highlighting intratumoral heterogeneity and stromal activity not fully appreciated by conventional SUV-based metrics. |
| format | Preprint |
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arxiv_https___arxiv_org_abs_2511_08812 |
| institution | arXiv |
| publishDate | 2025 |
| record_format | arxiv |
| spellingShingle | Per-Lesion Radiomics Analysis of 68Ga-DOTA FAPI-46 and 18F-FDG PET/CT in Non-Small Cell Lung Cancer: A pilot Study Hasanabadi, Setareh Cheraghi, Maryam Manesh, Hossein Behnam Bayat, Mohadeseh Karam, Mehrdad Bakhshayesh Corsi, Andrea Salimi, Yazdan Azimi, Mohammad Saber Doroudinia, Abtin Karami, Arezu Arabi, Hossein Medical Physics This pilot study compares per-lesion radiomics features of [68Ga]-DOTA FAPI-46 and [18F]-FDG PET/CT in non-small cell lung cancer (NSCLC) to explore complementary insights into intratumoral heterogeneity beyond conventional SUV metrics, aiming to enhance lesion characterization and clinical decision-making. A total of 28 PET/CT scans (14 [18F]-FDG and 14 [68Ga]-DOTA FAPI-46) were acquired for the initial staging of biopsy-confirmed NSCLC. A total of 81 co-localized lesions (lung: 21, mediastinal lymph nodes: 42, bone: 18) were segmented, with radiomics features extracted via PyRadiomics after IBSI-compliant preprocessing. Paired per-lesion comparisons used t-tests or Wilcoxon signed-rank tests with Benjamini-Hochberg FDR correction. Significant differences (adjusted P < 0.05) were identified across intensity, texture, and shape features. In lung lesions, FAPI showed lower first-order metrics but higher variance and GLCM contrast, suggesting stromal heterogeneity. Mediastinal lymph nodes had fewer differences, with FAPI exhibiting lower run percentage (GLRLM: -0.298, -6.196, P=1.45E-08). Bone lesions showed extensive variations, including reduced FAPI entropy (e.g., Entropy: -1.743, -5.798, P=6.95E-08). Feature overlaps highlighted complementary stromal (FAPI) and metabolic (FDG) insights. This pilot study demonstrates that per-lesion radiomics can capture complementary biological information from FAPI and FDG PET in NSCLC, highlighting intratumoral heterogeneity and stromal activity not fully appreciated by conventional SUV-based metrics. |
| title | Per-Lesion Radiomics Analysis of 68Ga-DOTA FAPI-46 and 18F-FDG PET/CT in Non-Small Cell Lung Cancer: A pilot Study |
| topic | Medical Physics |
| url | https://arxiv.org/abs/2511.08812 |