Department of Nuclear Medicine, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy.
Nuclear Medicine Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, 10126 Turin, Italy.
Int J Mol Sci. 2023 Jun 14;24(12):10136. doi: 10.3390/ijms241210136.
Various papers have introduced the use of positron emission tomography (PET) with [Ga]Ga-radiolabeled fibroblast-activation protein inhibitor (FAPi) radiopharmaceuticals in different subtypes of gastric cancer (GC). Our aim was to assess the diagnostic performance of this novel molecular imaging technique in GC with a systematic review and meta-analysis. A straightforward literature search of papers concerning the diagnostic performance of FAP-targeted PET imaging was performed. Original articles evaluating this novel molecular imaging examination in both newly diagnosed GC patients and GC patients with disease relapse were included. The systematic review included nine original studies, and eight of them were also eligible for meta-analysis. The quantitative synthesis provided pooled detection rates of 95% and 97% for the assessment of primary tumor and distant metastases, respectively, and a pooled sensitivity and specificity of 74% and 89%, respectively, for regional lymph node metastases. Significant statistical heterogeneity among the included studies was found only in the analysis of the primary tumor detection rate (I = 64%). Conclusions: Beyond the limitations of this systematic review and meta-analysis (i.e., all the included studies were conducted in Asia, and using [F]FDG PET/CT as a comparator of the index test), the quantitative data provided demonstrate the promising diagnostic performance of FAP-targeted PET imaging in GC. Nevertheless, more prospective multicentric studies are needed to confirm the excellent performances of FAP-targeted PET in this cluster of patients.
各种文献已经介绍了使用正电子发射断层扫描（PET）与 [Ga]Ga 标记的成纤维细胞激活蛋白抑制剂（FAPi）放射性药物在不同亚型胃癌（GC）中的应用。我们的目的是通过系统评价和荟萃分析评估这种新型分子成像技术在 GC 中的诊断性能。我们对涉及 FAP 靶向 PET 成像诊断性能的文献进行了直接的文献检索。纳入了评估新型分子成像检查在初诊 GC 患者和 GC 复发患者中应用的原始文章。系统评价包括 9 项原始研究，其中 8 项也符合荟萃分析的条件。定量综合分析提供了用于评估原发性肿瘤和远处转移的汇总检测率分别为 95%和 97%，以及用于区域淋巴结转移的汇总敏感性和特异性分别为 74%和 89%。仅在原发性肿瘤检测率分析中发现了纳入研究之间存在显著的统计学异质性（I = 64%）。结论：尽管存在本系统评价和荟萃分析的局限性（即，所有纳入的研究均在亚洲进行，且将 [F]FDG PET/CT 作为指标试验的比较），但定量数据表明，FAP 靶向 PET 成像在 GC 中具有有前途的诊断性能。然而，需要更多前瞻性多中心研究来证实 FAP 靶向 PET 在这组患者中的优异表现。
