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Head-to-head comparison of the diagnostic performance between 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in colorectal cancer: a systematic review and meta-analysis

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Abstract

This study aimed to compare the detection rates of 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in colorectal cancer. A systematic search of major medical databases was conducted to identify studies up to September 2023. The primary outcome assessed was the detection rate of 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in the primary tumor. Pooled risk ratios with a 95% CI were calculated using random-effect models to adjust for heterogeneity. Eight studies were included in the meta-analysis. 68Ga-FAPI-04 PET/CT has higher uptakes in lymph nodes, bone, and peritoneal metastasis compared with 18F-FDG PET/CT. The detection rate of 68Ga-FAPI-04 PET/CT based on lesion was better for lymph node metastasis (RR = 0.63, 95% CI 0.47–0.84, P = 0.002) and peritoneal metastasis (RR = 0.52, 95% CI 0.32–0.85, P = 0.009), both imaging modalities had essentially the same diagnostic efficacy in primary tumor (RR = 0.99, 95% CI 0.96–1.02, P = 0.49). 68Ga-FAPI-04 as a highly promising PET/CT tracer was superior to 18F-FDG PET/CT in colorectal cancer, especially in detecting lymph node metastases and peritoneal metastases.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

FAPI:

Fibroblast activation protein inhibitor

FDG:

Fluorodeoxyglucose

CAFs:

Cancer-associated fibroblasts

PET/CT:

Positron emission tomography/computed tomography

SUV:

Standardized uptake value

TBR:

Target-to-background ratio

DR:

Detection rate

CRC:

Colorectal cancer

LN:

Lymph node

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Funding

This study was supported by the National Natural Science Foundation of China (NSFC, No. 82203394); Department of Science and Technology of Sichuan Province (No. 2021YFS0025); 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (Nos. 2019HXFH031, 20HXJS003); Post-Doctoral Research Project, West China Hospital, Sichuan University (Nos. 2021HXBH033, 20826041E4084); and the Ethicon Excellent in Surgery Grant (EESG, No. HZB-20190528-4).

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Authors and Affiliations

  1. Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China

    Zixuan Zhuang, Yang Zhang, Xuyang Yang, Xiangbing Deng & Ziqiang Wang

  2. Colorectal Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China

    Zixuan Zhuang, Yang Zhang, Xuyang Yang, Xiangbing Deng & Ziqiang Wang

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  1. Zixuan Zhuang
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  2. Yang Zhang
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Contributions

ZZ contributed the most to this article. ZZ designed the project, developed the search strategy, and wrote the manuscript. ZZ and YZ checked the search, and reviewed the manuscript. XY performed literature screening and data extraction and conducted the quality assessment of the included studies. XD carried out the data analysis. ZW reviewed the manuscript and finally approved the version to be published. All authors reviewed the manuscript.

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Correspondence to Ziqiang Wang.

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Informed consent Informed consent was obtained in accordance with the standards set forth by hospital regulations.

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Zhuang, Z., Zhang, Y., Yang, X. et al. Head-to-head comparison of the diagnostic performance between 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in colorectal cancer: a systematic review and meta-analysis. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04266-z

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