Objectives: This study aimed to compare the diagnostic efficiency of Ga-fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET) and F-fluorodeoxyglucose (F-FDG) PET in patients with head and neck cancer (HNC).
Data Sources: PubMed, Embase, Web of Science, and the Cochrane Library were used to perform a systemic search through June 26, 2024.
Methods: Studies comparing the diagnostic value of Ga-FAPI PET and F-FDG PET in patients with HNC were included. We performed a bivariate meta-analysis of diagnostic data and a meta-analysis of the quantitative parameters. The summary receiver operating characteristic curve was plotted, and publication bias was evaluated via Egger's test.
Results: The meta-analysis included 12 studies on 386 patients with HNC. Ga-FAPI PET had superior pooled sensitivity to F-FDG PET in detecting primary/recurrent tumors and distant metastases in both lesion-based analysis and patient-based analysis. Although the sensitivity of F-FDG PET for detecting lymph node metastases was greater than that of Ga-FAPI PET (0.93 [95% CI 0.83-0.97] vs. 0.82 [95% CI 0.63-0.93]), the specificity of F-FDG PET was lower than that of Ga-FAPI PET (0.36 [95% CI 0.01-0.96] vs. 0.97 [95% CI 0.53-1.00]). In addition, Ga-FAPI PET had a higher pooled mean maximum standardized uptake value for distant metastases (3.28 [95% CI 1.90-4.66]) and a higher pooled mean tumor-to-background ratio for primary/recurrent tumors (1.24 [95% CI 0.44-2.04]) than F-FDG PET.
Conclusion: Compared to F-FDG PET, Ga-FAPI PET has superior diagnostic accuracy in HNC lesions. Thus, Ga-FAPI PET may be a better tool for staging and restaging than F-FDG PET in patients with HNC.
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| http://dx.doi.org/10.1016/j.acra.2025.02.038 | DOI Listing |
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