Fibroblast-activation protein inhibitors based positron emission tomography (PET) for assessing lung disease: A...

The incidence of lung diseases has been increasing in recent years, especially lung cancer and interstitial lung disease. However, the diagnosis of lung diseases such as lung cancer and ILD still has some limitations. Therefore, finding an appropriate imaging agent and technique is of great clinical value for the diagnostic evaluation of lung diseases.

A thorough search of all relevant literature up to 20 June 2024 was undertaken. Studies evaluating lung lesions with FAPI PET were screened and patient diagnostic data were extracted. Risk of bias was checked by the QUADAS-2. Meta-analysis was performed in STATA17.0. Subgroups were analysed for the effectiveness of FAPI PET/CT in the diagnostic assessment of various lung diseases.

19 studies were finally sieved. Meta-analysis showed that the sensitivity of FAPI PET/CT for the detection of lung tumours was 0.99 (95% CI: 0.90-1.00), with a specificity of 0.82 (95% CI: 0.72-0.89). The sensitivity of FAPI PET/CT for the assessment of non-neoplastic lesions was 0.93 (95% CI: 0.72-0.99) and the specificity was 0.96 (95% CI: 0.79-0.99). Subgroup analysis showed that FAPI PET/CT had a sensitivity of 0.93 (95% CI: 0.83-0.97) in lung tumour staging (n = 397). In addition, the sensitivity and specificity of FAPI PET/CT were 0.80 (95% CI: 0.70-0.89) and 0.90 (95% CI: 0.84-0.96) for pneumonia, and 1.00 for assessing idiopathic pulmonary fibrosis.

Our results show that FAPI PET/CT has an excellent diagnostic performance for lung tumours and non-tumour lesions.Points for clinical research: Currently CT is unable to accurately determine the activity of lung diseases such as IPF and hence may lead to delays in the diagnosis and treatment of some lung diseases. We aimed to find evidence-based medical evidence suitable for FAPI PET in lung diseases, especially non-oncological diseases, by performing a meta-analysis of FAPI PET in assessing lung diseases.