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.
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。