Comparison of ⁶⁸Ga-FAPI-04 and ¹⁸F-FDG PET/CT in diagnosing ovarian cancer

This study assesses the diagnostic performance of ⁶⁸Ga-FAPI-04 PET/CT compared to ¹⁸F-FDG PET/CT in primary, recurrent, and metastatic ovarian cancer.

Seventy-nine ovarian cancer patients who performed ⁶⁸Ga-FAPI-04 and ¹⁸F-FDG PET/CT were recruited. The target-to-background ratio (TBR), maximum standardized uptake value (SUV_max), the number of positive lesions, visual assessment, the peritoneal cancer index (PCI) score, staging/restaging, and treatment strategies were compared from the corresponding PET/CT. Additionally, we analyzed and contrasted the diagnostic efficacy in both scans.

Among all patients, 6 were assessed for initial assessment and 73 for recurrence and metastasis detection. For all lesions, ⁶⁸Ga-FAPI-04 PET/CT demonstrated greater TBR than ¹⁸F-FDG PET/CT. ⁶⁸Ga-FAPI-04 PET/CT demonstrated higher sensitivity for peritoneal metastases including patient-based and lesion-based analysis (95.00% vs. 83.33%, P = 0.065; 90.16% vs. 60.66%, P < 0.001) and a higher PCI score [median PCI: 6 (4, 12) vs. 4 (2, 8), P < 0.001]. According to the visual assessment, ⁶⁸Ga-FAPI-04 PET revealed larger extent metastases in 55.93% (33/59) of the patients with peritoneal metastases. ⁶⁸Ga-FAPI-04 was upstaged in 7 patients (8.86%, 7/79) and discrepancies in both scans caused treatment strategies to change in 11 patients (13.92%, 11/79).

⁶⁸Ga-FAPI-04 PET/CT outperforms ¹⁸F-FDG PET/CT in identifying metastases and can be a potential supplement for managing ovarian cancer patients.