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Purpose <p>The study aimed to compare the diagnostic accuracy of <sup>68</sup>Ga-DOTA-FAPI-04 (<sup>68</sup>Ga-FAPI) and <sup>18</sup>F-FDG PET/CT for peritoneal carcinomatosis (PC) in patients with various types of cancer.</p> Methods <p>The study enrolled 113 patients with suspected peritoneal malignancy, each of whom underwent <sup>68</sup>Ga-FAPI and <sup>18</sup>F-FDG PET/CT scans. Lesions in all patients were confirmed through pathology or radiological follow-up. The evaluation and comparison of diagnostic performance, visual scores, maximum standardized uptake value (SUV<sub>max</sub>), mean tumor-to-background ratio (TBR), and the peritoneal cancer index (PCI) score were conducted.</p> Results <p>Compared to <sup>18</sup>F-FDG, <sup>68</sup>Ga-FAPI PET/CT presented higher sensitivity, negative predictive value, and accuracy for detecting PC on a patient-level (100% vs. 93.2%, 100% vs. 22.22% and 93.81% vs. 86.73%, respectively). Semi-quantitative evaluation revealed that <sup>68</sup>Ga-FAPI PET/CT had significantly higher SUV<sub>max</sub> and TBR for PC [(6.06 ± 3.04 vs. 4.82 ± 2.75, <i>P</i> = 0.001) and (8.50 ± 5.01 vs. 2.92 ± 1.67, <i>P</i> &lt; 0.001)]. The PCI<sub>-FAPI</sub> score for PC was higher than the PCI<sub>-FDG</sub> score (11.28 ± 7.10 vs. 5.69 ± 5.15, <i>P</i> &lt; 0.001).</p> Conclusions <p><sup>68</sup>Ga-FAPI has demonstrated superior diagnostic accuracy compared to <sup>18</sup>F-FDG PET/CT in detecting PC with various types of cancer, particularly gastric cancer. Additionally, <sup>68</sup>Ga-FAPI has shown significantly higher uptake and PCI score in PC compared to <sup>18</sup>F-FDG, indicating its potential importance in clinical.</p>

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68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT: a head-to-head comparison for peritoneal carcinomatosis diagnostic accuracy

  • 期刊论文

  • 发表日期：

    2025年1月3日

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  • Xiaolin Chen,
  • Xiao Pang,
  • Yan Zhao,
  • Yunuan Liu,
  • Fenglian Jing,
  • Huiqing Yuan,
  • Xiaoshan Chen,
  • Tianyue Li,
  • Yingchen Wang,
  • Yali Liu,
  • Jingya Han,
  • Jingmian Zhang,
  • Jianfang Wang,
  • Zhaoqi Zhang,
  • Xinming Zhao

摘要

Purpose

The study aimed to compare the diagnostic accuracy of 68Ga-DOTA-FAPI-04 (68Ga-FAPI) and 18F-FDG PET/CT for peritoneal carcinomatosis (PC) in patients with various types of cancer.

Methods

The study enrolled 113 patients with suspected peritoneal malignancy, each of whom underwent 68Ga-FAPI and 18F-FDG PET/CT scans. Lesions in all patients were confirmed through pathology or radiological follow-up. The evaluation and comparison of diagnostic performance, visual scores, maximum standardized uptake value (SUVmax), mean tumor-to-background ratio (TBR), and the peritoneal cancer index (PCI) score were conducted.

Results

Compared to 18F-FDG, 68Ga-FAPI PET/CT presented higher sensitivity, negative predictive value, and accuracy for detecting PC on a patient-level (100% vs. 93.2%, 100% vs. 22.22% and 93.81% vs. 86.73%, respectively). Semi-quantitative evaluation revealed that 68Ga-FAPI PET/CT had significantly higher SUVmax and TBR for PC [(6.06 ± 3.04 vs. 4.82 ± 2.75, P = 0.001) and (8.50 ± 5.01 vs. 2.92 ± 1.67, P < 0.001)]. The PCI-FAPI score for PC was higher than the PCI-FDG score (11.28 ± 7.10 vs. 5.69 ± 5.15, P < 0.001).

Conclusions

68Ga-FAPI has demonstrated superior diagnostic accuracy compared to 18F-FDG PET/CT in detecting PC with various types of cancer, particularly gastric cancer. Additionally, 68Ga-FAPI has shown significantly higher uptake and PCI score in PC compared to 18F-FDG, indicating its potential importance in clinical.