Abstract：
OBJECTIVE: Our study aims to head to head compare the application of gallium-68-fibroblast activation protein inhibitor (68Ga-FAPI) positron emission tomography/computed tomography (PET/CT) and fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT in primary and metastatic lesions of gastric tumor to determine the superior diagnostic tool.
METHODS: A systematic search, up to March 31, 2023, across PubMed, Embase, and Cochrane Library databases utilized a data-specific Boolean logic strategy. Sensitivity (SEN) and specificity (SPE) evaluations of 68Ga-FAPI and 18F-FDG PET/CT in gastric cancer lesions were conducted. The quality of the studies was assessed using QUADAS-2, and publication bias was examined through Begg and Egger tests.
RESULTS: Analysis involved 141 gastric tumor patients and 2753 metastatic lesions in five studies, with overall satisfactory study quality and no apparent publication bias. Patient-level data showed a combined SEN of 0.95 (95% CI: 0.90-0.98) for 68Ga-FAPI and 0.84 (95% CI: 0.77-0.89) for 18F-FDG. At the lesion level, combined SEN were 0.91 (95% CI: 0.84-0.96) for 68Ga-FAPI and 0.72 (95% CI: 0.63-0.80) for 18F-FDG. The pooled SEN for detecting lymph node metastases was 0.78 (95% CI: 0.74-0.82) for 68Ga-FAPI and 0.35 (95% CI: 0.30-0.39) for 18F-FDG, with pooled SPE values of 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. For detecting distant metastases, pooled SEN values were 0.97 (95% CI: 0.96-0.98) and 0.69 (95% CI: 0.66-0.72) for 68Ga-FAPI and 18F-FDG, with pooled SPE values of 0.86 (95% CI: 0.82-0.89) and 0.64 (95% CI: 0.59-0.68), respectively.
CONCLUSIONS: This meta-analysis concluded that 68Ga-FAPI PET/CT was significantly more sensitive than 18F-FDG PET/CT in assessing primary gastric tumors, lymph nodes, and distant metastases, but the difference in the specificity of lymph node metastasis was not significant.
METHODS: A systematic search, up to March 31, 2023, across PubMed, Embase, and Cochrane Library databases utilized a data-specific Boolean logic strategy. Sensitivity (SEN) and specificity (SPE) evaluations of 68Ga-FAPI and 18F-FDG PET/CT in gastric cancer lesions were conducted. The quality of the studies was assessed using QUADAS-2, and publication bias was examined through Begg and Egger tests.
RESULTS: Analysis involved 141 gastric tumor patients and 2753 metastatic lesions in five studies, with overall satisfactory study quality and no apparent publication bias. Patient-level data showed a combined SEN of 0.95 (95% CI: 0.90-0.98) for 68Ga-FAPI and 0.84 (95% CI: 0.77-0.89) for 18F-FDG. At the lesion level, combined SEN were 0.91 (95% CI: 0.84-0.96) for 68Ga-FAPI and 0.72 (95% CI: 0.63-0.80) for 18F-FDG. The pooled SEN for detecting lymph node metastases was 0.78 (95% CI: 0.74-0.82) for 68Ga-FAPI and 0.35 (95% CI: 0.30-0.39) for 18F-FDG, with pooled SPE values of 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. For detecting distant metastases, pooled SEN values were 0.97 (95% CI: 0.96-0.98) and 0.69 (95% CI: 0.66-0.72) for 68Ga-FAPI and 18F-FDG, with pooled SPE values of 0.86 (95% CI: 0.82-0.89) and 0.64 (95% CI: 0.59-0.68), respectively.
CONCLUSIONS: This meta-analysis concluded that 68Ga-FAPI PET/CT was significantly more sensitive than 18F-FDG PET/CT in assessing primary gastric tumors, lymph nodes, and distant metastases, but the difference in the specificity of lymph node metastasis was not significant.
摘要：
目的：我们的研究旨在比较镓-68-成纤维细胞活化蛋白抑制剂（68Ga-FAPI）正电子发射断层扫描/计算机断层扫描（PET/CT）和氟-18-氟脱氧葡萄糖（18F-FDG）PET/CT在胃肿瘤原发灶和转移灶中的应用，以确定优越的诊断工具。
方法：系统搜索，截至2023年3月31日，整个PubMed，Embase,和CochraneLibrary数据库使用了特定于数据的布尔逻辑策略。对胃癌病灶中68Ga-FAPI和18F-FDGPET/CT的敏感性（SEN）和特异性（SPE）进行评估。使用QUADAS-2评估研究质量，并通过Begg和Egger测试检查发表偏倚。
结果：在五项研究中，分析涉及141例胃肿瘤患者和2753例转移灶，总体研究质量令人满意，没有明显的发表偏倚。患者水平数据显示，68Ga-FAPI的组合SEN为0.95（95％CI：0.90-0.98），18F-FDG的组合SEN为0.84（95％CI：0.77-0.89）。在病变级别，68Ga-FAPI的合并SENs为0.91(95%CI:0.84-0.96),18F-FDG的合并SENs为0.72(95%CI:0.63-0.80).68Ga-FAPI检测淋巴结转移的合并SEN为0.78（95％CI：0.74-0.82），18F-FDG为0.35（95％CI：0.30-0.39），合并的SPE值为0.99（95%CI：0.98-0.99）和0.97（95%CI：0.96-0.98），分别。为了检测远处转移，68Ga-FAPI和18F-FDG的合并SEN值分别为0.97(95%CI:0.96-0.98)和0.69(95%CI:0.66-0.72)，合并的SPE值为0.86（95%CI：0.82-0.89）和0.64（95%CI：0.59-0.68），分别。
结论：这项荟萃分析得出结论，在评估原发性胃肿瘤方面，68Ga-FAPIPET/CT比18F-FDGPET/CT更敏感，淋巴结,和远处转移，但淋巴结转移的特异性差异无统计学意义。
方法：系统搜索，截至2023年3月31日，整个PubMed，Embase,和CochraneLibrary数据库使用了特定于数据的布尔逻辑策略。对胃癌病灶中68Ga-FAPI和18F-FDGPET/CT的敏感性（SEN）和特异性（SPE）进行评估。使用QUADAS-2评估研究质量，并通过Begg和Egger测试检查发表偏倚。
结果：在五项研究中，分析涉及141例胃肿瘤患者和2753例转移灶，总体研究质量令人满意，没有明显的发表偏倚。患者水平数据显示，68Ga-FAPI的组合SEN为0.95（95％CI：0.90-0.98），18F-FDG的组合SEN为0.84（95％CI：0.77-0.89）。在病变级别，68Ga-FAPI的合并SENs为0.91(95%CI:0.84-0.96),18F-FDG的合并SENs为0.72(95%CI:0.63-0.80).68Ga-FAPI检测淋巴结转移的合并SEN为0.78（95％CI：0.74-0.82），18F-FDG为0.35（95％CI：0.30-0.39），合并的SPE值为0.99（95%CI：0.98-0.99）和0.97（95%CI：0.96-0.98），分别。为了检测远处转移，68Ga-FAPI和18F-FDG的合并SEN值分别为0.97(95%CI:0.96-0.98)和0.69(95%CI:0.66-0.72)，合并的SPE值为0.86（95%CI：0.82-0.89）和0.64（95%CI：0.59-0.68），分别。
结论：这项荟萃分析得出结论，在评估原发性胃肿瘤方面，68Ga-FAPIPET/CT比18F-FDGPET/CT更敏感，淋巴结,和远处转移，但淋巴结转移的特异性差异无统计学意义。
