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Updated: Jun 21, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Diagnostic performance of FAPI PET/CT for the detection of peritoneal metastases: an updated systematic review and
Wan Qi-Chang1, Min Kai-Yin2, Wang Cheng-Yi3
1Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun 130033, China; Department of Nuclear Medicine, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan 511500, China.
Purpose:
To perform an updated systematic review and meta-analysis on the diagnostic accuracy of FAPI PET/CT in detecting peritoneal metastases (PM) in various cancer patients.
Methods:
The PubMed and Embase databases were searched through January 2026 to identify relevant articles. We included studies reporting the diagnostic accuracy of FAPI PET/CT in detecting PM in cancer patients, using histopathology and/or a multidisciplinary approach as the reference standard. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristics curve (AUC) were determined by using a bivariate random-effects model.
Results:
Fifteen studies with 837 patients were eligible, of which nine provided patient-level data, five provided lesion-level data, and one provided both types of data. On patient-based analysis, the pooled sensitivity, specificity, and AUC value for FAPI PET/CT in detecting PM were 97 % (95 % CI, 91-99 %), 95 % (95 % CI, 80-99 %), and 0.99 (95 % CI, 0.98-1.00), respectively. On lesion-based analysis, the pooled sensitivity, specificity, and AUC value for FAPI PET/CT in detecting PM were 92 % (95 % CI, 83-96 %), 90 % (95 % CI, 70-97 %), and 0.96 (95 % CI, 0.94-0.97), respectively. Of note, lesion-based data from four ovarian cancer studies showed a pooled sensitivity of 92 % (95 % CI, 79-97 %) and a pooled specificity of 96 % (95 % CI, 85-99 %).
Conclusion:
This updated meta-analysis showed that FAPI PET/CT has promising and clinically relevant diagnostic performance for the detection of PM in both patient-based and lesion-based analyses. These findings support its value for evaluating the presence and extent of peritoneal involvement, particularly in PM-prone cancers such as ovarian cancer, while further prospective validation is still warranted.
Insights
Fibroblast activation protein (FAPI) PET/CT shows high accuracy in detecting peritoneal metastases (PM) across various cancers. This updated meta-analysis confirms its clinical relevance for evaluating peritoneal involvement, especially in ovarian cancer.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- Peritoneal metastases (PM) significantly impact cancer patient prognosis.
- Accurate detection of PM is crucial for treatment planning and management.
- FAPI PET/CT is an emerging imaging modality for cancer detection.
Purpose of the Study:
- To conduct an updated systematic review and meta-analysis.
- To evaluate the diagnostic accuracy of FAPI PET/CT in detecting PM.
- To assess its performance in various cancer types.
Main Methods:
- Systematic search of PubMed and Embase databases up to January 2026.
- Inclusion of studies reporting FAPI PET/CT diagnostic accuracy for PM.
- Utilized histopathology and/or multidisciplinary approach as the reference standard.
- Bivariate random-effects model for pooled sensitivity, specificity, and AUC.
Main Results:
- Fifteen studies with 837 patients were included.
- Patient-based analysis: pooled sensitivity 97%, specificity 95%, AUC 0.99.
- Lesion-based analysis: pooled sensitivity 92%, specificity 90%, AUC 0.96.
- Ovarian cancer subgroup showed high sensitivity (92%) and specificity (96%).
Conclusions:
- FAPI PET/CT demonstrates promising and clinically relevant diagnostic performance for PM detection.
- Supports its utility in assessing peritoneal involvement, particularly in high-risk cancers like ovarian cancer.
- Further prospective validation is recommended.
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