Comparison of the diagnostic accuracy of [ 68 Ga]Ga-Trivehexin PET/computed tomography and [ 18 F]FDG PET/computed tomography in nodal staging of various solid tumors.

OBJECTIVE

The aim of this retrospective study is to evaluate the diagnostic accuracy of [ 68 Ga]Ga-Trivehexin PET/CT compared with [ 18 F]fluorodeoxyglucose (FDG) PET/computed tomography (CT) for nodal staging in various solid tumors.

MATERIALS AND

METHODS

Between 2024 and 2025, a total of 15 patients with histopathologically confirmed primary or recurrent cancer were enrolled in the study. All participants underwent both [ 18 F]FDG and [ 68 Ga]Ga-Trivehexin PET/CT imaging for oncologic staging. Imaging findings were compared with histopathological results and clinical/radiological follow-up. Primary tumors, lymph nodes, and metastases were visually assessed, and maximum standardized uptake values were calculated.

RESULTS

The median age of the patients was 62 years. Diagnoses included colorectal, breast, pancreatic, lung, bladder, thyroid, and endometrial cancers. Both [ 18 F]FDG and [ 68 Ga]Ga-Trivehexin PET/CT demonstrated uptake in all primary tumors. While [ 18 F]FDG PET/CT showed uptake in all lymph nodes, [ 68 Ga]Ga-Trivehexin PET/CT demonstrated positive uptake only in metastatic lymph nodes. The positive predictive value of [ 68 Ga]Ga-Trivehexin PET/CT was calculated as 100%. In contrast, [ 18 F]FDG PET/CT exhibited lower specificity, with a positive predictive value of 26.3%.

CONCLUSION

This study demonstrates that [ 68 Ga]Ga-Trivehexin PET/CT offers higher specificity than [ 18 F]FDG PET/CT, particularly in benign lymph node lesions, and is effective in accurately identifying metastatic lymph nodes. Compared to [ 18 F]FDG PET/CT, 68 Ga-Trivehexin PET/CT provides lower false-positive rates and higher diagnostic accuracy, potentially reducing the need for unnecessary invasive procedures.