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

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.

Keywords: 18F-FDG; 68Ga-FAPI-04; Colorectal cancer; Meta-analysis; PET/CT.