⁶⁸Ga-FAPI-04 PET for Detecting Occult Peritoneal Metastasis in Locally Advanced Gastric Cancer: Diagnostic...

Area of Science:

• Oncology
• Nuclear Medicine
• Diagnostic Imaging

Background:

• Occult peritoneal metastasis (OPM) is a frequent challenge in locally advanced gastric cancer.
• Accurate detection of OPM is crucial for appropriate treatment planning and patient management.

Purpose of the Study:

• To evaluate the diagnostic accuracy of 68Ga-FAPI-04 PET/CT for detecting OPM in locally advanced gastric cancer.
• To assess the cost-effectiveness of 68Ga-FAPI-04 PET/CT compared to standard laparoscopic staging.

Main Methods:

• A prospective cohort study involving 109 patients with locally advanced gastric adenocarcinoma.
• All patients underwent 68Ga-FAPI-04 PET/CT prior to laparoscopic staging.
• Laparoscopic staging with peritoneal washing cytology served as the gold standard for OPM diagnosis.

Main Results:

• 68Ga-FAPI-04 PET/CT identified OPM in 15.6% of patients, leading to upstaging.
• The imaging demonstrated high diagnostic accuracy: 75.0% sensitivity, 94.6% specificity, and 91.7% accuracy (AUC 0.83).
• Economic analysis revealed significant cost savings, with a net reduction of $979.30 per patient compared to laparoscopic staging alone.

Conclusions:

• 68Ga-FAPI-04 PET/CT is a highly accurate imaging modality for detecting OPM in locally advanced gastric cancer.
• The technique offers substantial cost savings and reduces the need for invasive procedures.
• 68Ga-FAPI-04 PET/CT shows promise as a valuable tool, potentially replacing or supplementing laparoscopic staging.