FAPI PET Versus FDG PET/CT in Gastrointestinal Cancers: An Overview

Area of Science:

• Oncology
• Radiology
• Molecular Imaging

Background:

• Fibroblast activation protein (FAP) is overexpressed in cancer-associated fibroblasts (CAFs) in various cancers, correlating with poor prognosis and treatment resistance.
• Radiolabeled FAP inhibitors (FAPI) for PET imaging show clinical utility across cancers, especially in gastrointestinal (GI) malignancies with desmoplastic reactions.

Purpose of the Study:

• To comprehensively compare FAPI PET and [18F]FDG PET in GI cancers for diagnosis, staging, and treatment guidance.
• To review the expanding role of FAPI PET in assessing treatment response and predicting prognosis in GI malignancies.

Main Methods:

• Review of clinical studies comparing FAPI PET and [18F]FDG PET in GI cancers.
• Analysis of FAPI PET applications in diagnosis, staging, treatment response assessment, and prognosis prediction.

Main Results:

• FAPI PET demonstrates potential as a complementary method to [18F]FDG PET in GI cancers, overcoming limitations like low sensitivity and high background uptake.
• FAPI PET shows promise in enhancing diagnostic accuracy and treatment guidance for GI malignancies.

Conclusions:

• FAPI PET offers significant potential to improve the management of GI malignancies.
• Further insights into FAPI PET's role in treatment response and prognosis prediction are expected to enhance patient care.