Comparison of the diagnostic accuracy of [68Ga]Ga-Trivehexin PET/computed tomography and [18F]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.