Comparison of the diagnostic value of ⁶⁸Ga-FAPI and ¹⁸F-FDG PET/CT in breast cancer: a systematic review

Although ¹⁸F-FDG PET/CT is helpful in detecting primary breast cancer and its distant metastases, ⁶⁸Ga-FAPI PET/CT may perform better in detecting primary breast cancers at an earlier stage and metastatic lesions (lymph node, etc.). This study aimed to systematically review the diagnostic value of ⁶⁸Ga-FAPI PET/CT versus ¹⁸F-FDG PET/CT in terms of diagnostic accuracy parameters (sensitivity, specificity) and quantitative parameters (SUVmax, TBR, etc.) for the diagnosis of primary and metastatic lesions of breast cancer.

This study followed the PRISMA guidelines for systematic reviews. A comprehensive search of the PubMed, EMBASE and Web of Science databases was performed to identify studies that met the eligibility criteria from 2000–01 to 2023–07. The quality of the relevant studies with the QUADAS-2 method was assessed via ReviewManager v.5 software. The literature included female breast cancer patients with the pathologic type of invasive carcinoma who had received both ¹⁸F-FDG and ⁶⁸Ga-FAPI PET/CT.

A total of 238 documents were retrieved, and 6 were ultimately included. The results revealed that ⁶⁸Ga-FAPI PET/CT had a greater SUVmax, TBR, and sensitivity than FDG did.

In this study, we compared the value of ⁶⁸Ga-FAPI PET/CT and ¹⁸F-FDG PET/CT in breast cancer patients. For both primary and metastatic foci of breast cancer, ⁶⁸Ga-FAPI PET/CT resulted in a higher lesion detection rate and tracer uptake. Second, ⁶⁸Ga-FAPI PET/CT can improve patient staging and provide some prognostic information, including the pathological response. In addition, ⁶⁸Ga-FAPI PET/CT imaging can detect additional lesions as a complementary tool.

https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42023491138).