Head-to-head comparison of the diagnostic performance between 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in colorectal cancer: a systematic review and meta-analysis

This study aimed to compare the detection rates of 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT in colorectal cancer. A systematic search of major medical databases was conducted to identify studies up to September 2023. The primary outcome assessed was the detection rate of 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT in the primary tumor. Pooled risk ratios with a 95% CI were calculated using random-effect models to adjust for heterogeneity. Eight studies were included in the meta-analysis. 68 Ga-FAPI-04 PET/CT has higher uptakes in lymph nodes, bone, and peritoneal metastasis compared with 18 F-FDG PET/CT. The detection rate of 68 Ga-FAPI-04 PET/CT based on lesion was better for lymph node metastasis (RR = 0.63, 95% CI 0.47–0.84, P = 0.002) and peritoneal metastasis (RR = 0.52, 95% CI 0.32–0.85, P = 0.009), both imaging modalities had essentially the same diagnostic efficacy in primary tumor (RR = 0.99, 95% CI 0.96–1.02, P = 0.49). 68 Ga-FAPI-04 as a highly promising PET/CT tracer was superior to 18 F-FDG PET/CT in colorectal cancer, especially in detecting lymph node metastases and peritoneal metastases.