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European Radiology
Published in: European Radiology 2/2024

17-08-2023 | Lung Cancer | Chest

Performance of [18F]FDG PET/CT versus FAPI PET/CT for lung cancer assessment: a systematic review and meta-analysis

Authors: Qiuya Yang, Delong Huang, Junhao Wu, Haoshu Zhong, YuanHang Han, Haodong Jiang, Yue Chen, Gong Chen, Xiang Zhan, Ping Zhou

Published in: European Radiology | Issue 2/2024

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Abstract

Purpose

This article aims to compare the diagnostic performance of 18-fluorodeoxyglucose ([18F]FDG) PET/CT and fibroblast activating protein inhibitor (FAPI) PET/CT in the assessment of primary tumors, lymph nodes, and distant metastases in lung cancer patients.

Methods

A systematic search was conducted on the Cochrane Library, Embase, and PubMed/MEDLINE databases from inception until November 1, 2022. Included studies assessed the use of FAPI PET/CT and [18F]FDG PET/CT in patients with lung cancer. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to evaluate the risk of bias. A random variable model was used to analyze the diagnostic tests of the two imaging modalities.

Results

The sensitivity of FAPI PET/CT in detecting primary lung cancer lesions was 0.98 (95% CI: 0.88–1.00), while the sensitivity of [18F]FDG PET/CT was 0.99 (95% CI: 0.74–1.00). For the detection of metastatic lesions (lymph node metastases and distant metastases), FAPI PET/CT had a sensitivity of 0.99 (95% CI: 0.90–1.00), while the sensitivity of [18F]FDG PET/CT was 0.77 (95% CI: 0.66–0.85). However, the specificity of the two imaging modalities could not be assessed due to the lack of sufficient information on pertinent true negatives.

Conclusion

In the diagnosis of metastatic lung cancer lesions, FAPI PET/CT demonstrated a higher sensitivity compared to [18F]FDG PET/CT. Therefore, FAPI PET/CT may be considered an alternative imaging modality for the assessment of primary lung cancer tumors, lymph node metastases, and distant metastases.

Clinical relevance statement

FAPI may be an alternative to [18F]FDG in the assessment of primary lung cancer tumors, lymph node metastases, and distant metastases, which plays a very important role in treatment.

Key Points

• This article is to compare the performance of [18F]FDG PET/CT with FAPI PET/CT in the assessment of primary tumors, lymph nodes, and distant metastases in lung cancer.
• However, FAPI PET/CT has a higher sensitivity for the diagnostic assessment of metastatic lung cancer lesions.
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Metadata
Title
Performance of [18F]FDG PET/CT versus FAPI PET/CT for lung cancer assessment: a systematic review and meta-analysis
Authors
Qiuya Yang
Delong Huang
Junhao Wu
Haoshu Zhong
YuanHang Han
Haodong Jiang
Yue Chen
Gong Chen
Xiang Zhan
Ping Zhou
Publication date
17-08-2023
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-10013-7

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