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Background <p>Nuclear medicine imaging plays a pivotal role in gastrointestinal (GI) tumour staging and management. [18F] FDG PET CT remains the standard metabolic imaging modality, but its efficacy can be limited in certain GI cancers due to variable glucose metabolism. [68&#xa0;Ga] Ga FAPI-04 PET CT has emerged as a promising alternative, targeting fibroblast activation protein expressed in cancer-associated stromal cells.</p> Objective <p>To evaluate and compare the diagnostic performance of [68&#xa0;Ga] Ga FAPI-04 PET CT versus [18F] FDG PET CT in staging gastrointestinal tumours.</p> Methods <p>This retrospective study included 55 patients with suspected or confirmed GI malignancies (excluding lymphomas) referred for staging at Aster Whitefield Hospital between February 2024 and May 2025. All patients underwent both [18F] FDG PET CT and [68&#xa0;Ga] Ga FAPI-04 PET CT within a 7-day interval. Sensitivity and lesion detection rates were calculated using histopathology as the reference standard.</p> Results <p>Among 55 patients (31 males, 24 females; median age 58&#xa0;years), [68&#xa0;Ga] Ga FAPI-04 PET CT demonstrated superior sensitivity (97.4% vs 85.2%) compared to [18F] FDG PET CT. [68&#xa0;Ga] Ga FAPI-04 PET CT detected 112 of 115 lesions versus 98 lesions with [18F] FDG PET CT (<i>p</i> = 0.02). [68&#xa0;Ga] Ga FAPI-04 showed particular advantage in detecting metastases in liver, peritoneum, and lymph nodes. Additionally, [68&#xa0;Ga] Ga FAPI-04 PET CT offered patient comfort benefits with shorter scan time (30&#xa0;min vs 75&#xa0;min) and reduced fasting requirements (2–3&#xa0;h vs 6–8&#xa0;h).</p> Conclusion <p>[68&#xa0;Ga] Ga FAPI-04 PET CT outperforms [18F] FDG PET CT in staging GI tumours, especially in cases with abundant stromal involvement, while offering improved patient convenience. These findings support the clinical adoption of [68&#xa0;Ga] Ga FAPI-04 PET CT for GI cancer imaging.</p>

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Retrospective Analysis of a Prospective Institutional Database: Comparative Evaluation of [⁶⁸Ga] FAPI‑04 PET/CT versus [18F] FDG PET/CT in Staging Gastrointestinal Tumors - A Single‑Center Study

  • 期刊论文

  • 发表日期：

    2026年7月30日

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  • S. P. Somashekar,
  • Prathap Jayachandra Hosahalli,
  • Omkar Sahindrakar,
  • K. R. Ashwin,
  • C. Rohit Kumar,
  • Mita Kumarswamy Kallur,
  • Kushal Agrawal,
  • B. R. Abhijith,
  • B. R. Ajay,
  • Sneha Kommineni,
  • Harin Anjaneyareddy,
  • Namita Sinha Verma,
  • Esha R. Shanbhag,
  • Nishitha Prashanth,
  • M. S. Belliappa,
  • Ainu Mariam Sabu

摘要

Background

Nuclear medicine imaging plays a pivotal role in gastrointestinal (GI) tumour staging and management. [18F] FDG PET CT remains the standard metabolic imaging modality, but its efficacy can be limited in certain GI cancers due to variable glucose metabolism. [68 Ga] Ga FAPI-04 PET CT has emerged as a promising alternative, targeting fibroblast activation protein expressed in cancer-associated stromal cells.

Objective

To evaluate and compare the diagnostic performance of [68 Ga] Ga FAPI-04 PET CT versus [18F] FDG PET CT in staging gastrointestinal tumours.

Methods

This retrospective study included 55 patients with suspected or confirmed GI malignancies (excluding lymphomas) referred for staging at Aster Whitefield Hospital between February 2024 and May 2025. All patients underwent both [18F] FDG PET CT and [68 Ga] Ga FAPI-04 PET CT within a 7-day interval. Sensitivity and lesion detection rates were calculated using histopathology as the reference standard.

Results

Among 55 patients (31 males, 24 females; median age 58 years), [68 Ga] Ga FAPI-04 PET CT demonstrated superior sensitivity (97.4% vs 85.2%) compared to [18F] FDG PET CT. [68 Ga] Ga FAPI-04 PET CT detected 112 of 115 lesions versus 98 lesions with [18F] FDG PET CT (p = 0.02). [68 Ga] Ga FAPI-04 showed particular advantage in detecting metastases in liver, peritoneum, and lymph nodes. Additionally, [68 Ga] Ga FAPI-04 PET CT offered patient comfort benefits with shorter scan time (30 min vs 75 min) and reduced fasting requirements (2–3 h vs 6–8 h).

Conclusion

[68 Ga] Ga FAPI-04 PET CT outperforms [18F] FDG PET CT in staging GI tumours, especially in cases with abundant stromal involvement, while offering improved patient convenience. These findings support the clinical adoption of [68 Ga] Ga FAPI-04 PET CT for GI cancer imaging.