[Ga-68]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [F-18]-FDG PET MRI/CT: a meta-analysis

ObjectivesTo compare the detection rates of [Ga-68]Ga-FAPI-04 PET MRI/CT vs. [F-18]-FDG PET MRI/CT in gastric cancer.MethodsAn extensive librarian-led literature search of PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov was performed. The primary outcomes were sensitivity in patient-based evaluations, detection of lymph node metastases, and peritoneal involvement.ResultsFive studies, including 148 participants, were analyzed. [Ga-68]Ga-FAPI-04 PET MRI/CT has a comparatively high sensitivity in patient-based evaluations compared with [F-18]-FDG PET MRI/CT (risk difference = 0.16, 95% CI 0.09-0.22, P < 0.00001). The [Ga-68]Ga-FAPI-04 PET MRI/CT group has a comparatively higher sensitivity in detecting lymph node metastases (RR = 0.15, 95% CI 0.01-0.29, P = 0.04), peritoneal involvement (RR = 0.55, 95% CI 0.38-0.72, P < 0.00001) in gastric cancer than [F-18]-FDG PET MRI/CT group.ConclusionsThis systematic review confirmed the advantage of [Ga-68]Ga-FAPI-04 PET MRI/CT in gastric cancer. [Ga-68]Ga-FAPI-04 PET MRI/CT was superior to [F-18]-FDG PET MRI/CT in detecting the primary tumor, lymph node metastases, and peritoneal metastases. More studies are needed for the sensitivity and specificity of [Ga-68]Ga-FAPI-04 PET MRI/CT in different pathological types of gastric cancer.