Comparison of the Detection Performance Between FAP and FDG PET/CT in Various Cancers

医学 成纤维细胞活化蛋白 接收机工作特性 诊断优势比 转移 荟萃分析 原发性肿瘤 科克伦图书馆 优势比 肿瘤科 正电子发射断层摄影术 癌症 内科学 放射科
作者
Wen-Yi Chang,Neng-Chuan Tseng,Liyu Chen,Chun Ju Chang,Ya-Yao Huang,Ya-Ting Huang,Yen‐Chuan Ou,Nan‐Jing Peng
出处
期刊:Clinical Nuclear Medicine [Ovid Technologies (Wolters Kluwer)]
卷期号:48 (2): 132-142 被引量:4
标识
DOI:10.1097/rlu.0000000000004438
摘要

18F-FDG is the dominant radiotracer in oncology; however, it has limitations. Novel labeled fibroblast activation protein (FAP) radiotracers have been developed and published in several studies. Thus, this meta-analysis aimed to compare the detection rates (DRs) of FDG and FAP, based on previous studies from a systematic review.PubMed/MEDLINE and Cochrane library databases were used to perform a comprehensive and systematic search and are updated to April 30, 2022. The DR, relative risk, and the SUVmax were calculated between the FAP and FDG tracers. Finally, the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of FAP and FDG were analyzed using gold and reference standards.Thirty studies (1170 patients) were included in the meta-analysis. The relative risks of FAP DR for the primary tumor, recurrent tumor, lymph node metastasis, and distant metastasis were FDG 1.06- to 3.00-fold per patient and per lesion. For the primary tumor, FAP uptake was most intense in pancreatic cancer, followed by head and neck, cervical, colorectal, lung, gastric, and hepatocellular carcinoma, and was higher than FDG except for urological system cancer. The sensitivity (0.84-0.98), diagnostic odds ratio (19.36-358.47), and summary receiver operating characteristic curve (0.94-0.99) of FAP based on patient and lesion were better for primary tumors, LN metastasis, and distant metastasis than FDG.Fibroblast activation protein is an extremely potential radiotracer to replace most of the use of FDG in oncology. It is noteworthy that the FAP tracers for primary tumors had low specificity despite excellent sensitivity and had lower uptake than FDG in urological system cancer. In addition, the difference in detection between FAP and FDG for LN metastasis could not be certain in sarcoma.
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