Preoperative Assessment of Peritoneal Carcinomatosis with [68Ga]Ga-FAPI-46 PET/CT: Agreement with Surgicopathologic PCI and Comparison with MRI and [18F]FDG PET/CT
Abstract
Accurate preoperative mapping of peritoneal carcinomatosis (PC) is critical for selecting patients for cytoreductive surgery and guiding treatment planning. Conventional imaging, including [18F]FDG PET/CT (FDG PET), may underestimate PC extent. This study evaluated [68Ga]Ga-fibroblast activation protein inhibitor (FAPI)-46 PET/CT (FAPI PET) for preoperative PC assessment, examining agreement with the surgicopathologic reference standard and comparing its performance with MRI and FDG PET. Methods: In this prospective phase 2 study (FAPeCa, NCT06061874), patients with colorectal or ovarian cancer with known or suspected PC underwent FAPI PET, FDG PET, and MRI with diffusion-weighted imaging within 4 wk before diagnostic laparoscopy or cytoreductive surgery. PC extent was quantified using a 10-segment peritoneal cancer index (PCI) adaptation. Agreement with the reference standard was assessed using intraclass correlation coefficients (ICCs), and segment-level diagnostic performance was evaluated after dichotomization (PCI, 0 vs. ≥1). Subgroup analyses were performed based on recent chemotherapy status. Results: The analysis included 61 patients. Agreement with the reference standard was highest for FAPI PET (ICC, 0.81), followed by MRI (ICC, 0.76) and FDG PET (ICC, 0.54). Segment-level sensitivity, specificity, and accuracy were 77.6%, 71.2%, and 74.8% for FAPI PET; 67.0%, 84.4%, and 74.7% for MRI; and 47.5%, 91.8%, and 67.2% for FDG PET, respectively, with significantly higher…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 61 participants or records.
Read the paper
Related studies
- Preliminary Toxicity Analysis of 3DCRT versus IMRT on the High Dose Arm of the RTOG 0126 Prostate Cancer Trial
- Adaptive Radiotherapy for Head and Neck Cancer: Initial Clinical Outcomes from a Prospective Trial
- American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology
- Motion Management Strategies and Technical Issues Associated with Stereotactic Body Radiotherapy of Thoracic and Upper Abdominal Tumors: A Review from NRG Oncology
- High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial
- Highly efficient training, refinement, and validation of a knowledge-based plan quality control system for radiotherapy clinical trials
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.