Diagnostic value of ¹⁸F-FDG and ⁶⁸Ga-FAPI in head and neck cancers: A systematic review and meta-analysis.

IF 0.9 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Hellenic journal of nuclear medicine Pub Date : 2025-01-01 Epub Date: 2025-04-07 DOI:10.1967/s002449912786

Jiao Ma, Jiayu Zhang, Ting Zhao, Jia Deng, Chunyin Zhang

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引用次数: 0

Abstract

Objective: Gallium-68-labeled fibroblast activating protein inhibitor (⁶⁸Ga-FAPI) has been developed for positron emission tomography (PET) and proved to be a promising imaging agent. It has shown good diagnostic performance in the diagnosis of various solid tumors, including head and neck cancers (HNC). This study conducted a meta-analysis on the diagnostic performance of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) and ⁶⁸Ga-FAPI in HNC, summarized the clinical evidence of ⁶⁸Ga-FAPI for HNC, and compared the diagnostic sensitivity of the two imaging agents in the primary and metastatic lesions of HNC.

Materials and methods: PubMed/ Medline, Embase and Cochrane Library databases were searched from built to 31 January 2023. Studies on patients with HNC underwent paired ¹⁸F-FDG and ⁶⁸Ga-FAPI were included. Literature screening, full text review and data extraction were performed by 2 investigators. The risk of bias was examined with the QUADAS-2 tool. Meta-analysis of diagnostic test sensitivity was performed by a random-effect model and displayed by a forest plot.

Results: A total of 507 studies were comprehensively retrieved, and 11 studies, 297 patients were selected for the systematic review and 9 studies for meta-analysis. Two hundred and nine patients selected for initial staging and 88 patients for recurrence. Pooled sensitivity at initial stage was conducted. Based on primary lesions, the sensitivity were ¹⁸F-FDG 0.95 (0.81-0.99) vs ⁶⁸Ga-FAPI 0.99 (0.90-1.00). For lymph node metastases, based on patients, the sensitivity were ¹⁸F-FDG 0.99 (0.77-1.00) vs ⁶⁸Ga-FAPI 0.92 (0.68-0.98); For distant metastases, based on patients, the sensitivity were ¹⁸F-FDG 0.82 (0.03-1.00) vs ⁶⁸Ga-FAPI 0.92 (0.59-0.99).

Conclusion: Gallium-68-FAPI has great potential in the diagnosis of HNC and has similar diagnostic value with ¹⁸F-FDG. While there is much overlap in the performance (as measured by sensitivity) of these two agents but a trend may favor ⁶⁸Ga-FAPI over ¹⁸F-FDG for detection of primary tumor and distant metastases. Therefore, in the diagnosis and evaluation of head and neck cancers, the combination of ⁶⁸Ga-FAPI and ¹⁸F-FDG can be considered according to the individual situation.

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18F-FDG和68Ga-FAPI在头颈癌中的诊断价值：一项系统综述和meta分析。

目的：镓-68标记成纤维细胞激活蛋白抑制剂（68Ga-FAPI）已被开发用于正电子发射断层扫描（PET），并被证明是一种很有前途的显像剂。它在包括头颈癌（HNC）在内的各种实体肿瘤的诊断中显示出良好的诊断效果。本研究对氟-18-氟脱氧葡萄糖（18F-FDG）和68Ga-FAPI对HNC的诊断性能进行meta分析，总结68Ga-FAPI对HNC的临床证据，比较两种显像剂对HNC原发病变和转移病变的诊断敏感性。材料和方法：检索PubMed/ Medline、Embase和Cochrane图书馆数据库，检索时间为建成至2023年1月31日。纳入了对HNC患者进行配对18F-FDG和68Ga-FAPI的研究。2名研究者进行文献筛选、全文回顾和资料提取。使用QUADAS-2工具检查偏倚风险。诊断试验敏感性的meta分析采用随机效应模型，并用森林图表示。结果：综合检索507项研究，其中11项研究、297例患者纳入系统评价，9项研究纳入meta分析。229例患者为初始分期，88例患者为复发。初始阶段进行了集合灵敏度分析。基于原发病变，敏感性分别为18F-FDG 0.95（0.81-0.99）和68Ga-FAPI 0.99（0.90-1.00）。对于淋巴结转移，基于患者的敏感性分别为18F-FDG 0.99（0.77-1.00）和68Ga-FAPI 0.92 (0.68-0.98)；对于远处转移，基于患者，敏感性分别为18F-FDG 0.82（0.03-1.00）和68Ga-FAPI 0.92（0.59-0.99）。结论：镓-68- fapi在HNC诊断中具有很大的潜力，与18F-FDG具有相似的诊断价值。虽然这两种药物的性能（以灵敏度衡量）有很多重叠，但在检测原发肿瘤和远处转移瘤时，68Ga-FAPI可能比18F-FDG更受青睐。因此，在头颈部肿瘤的诊断和评价中，可根据个体情况考虑68Ga-FAPI与18F-FDG的联合使用。

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来源期刊

Hellenic journal of nuclear medicine 医学-核医学

CiteScore

1.40

自引率

6.70%

发文量

审稿时长

>12 weeks

期刊介绍： The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and cover the scientific and professional interests of physicians, in the field of nuclear medicine and in medicine in general. The journal may publish papers of nuclear medicine and also papers that refer to related subjects as dosimetry, computer science, targeting of gene expression, radioimmunoassay, radiation protection, biology, cell trafficking, related historical brief reviews and other related subjects. Original papers are preferred. The journal may after special agreement publish supplements covering important subjects, dully reviewed and subscripted separately.