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Abstract
Objective: The purpose of the current study was to compare the diagnostic performances of radiolabeled FAPI and 18 F-FDG PET/CT for the detection of lymph node (LN) metastasis in head and neck cancer (HNC) patients.

Methods: The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through December 31, 2024, were searched for studies comparing diagnostic performances of radiolabeled FAPI and 18 F-FDG PET/CT for the detection of metastatic LN in HNC patients. We estimated pooled sensitivities and specificities across studies.

Results: Across 8 studies (14 results), the pooled sensitivity of FAPI PET/CT was 0.89 and the pooled specificity was 0.93. The pooled sensitivity of 18 F-FDG PET/CT was 0.91 and the pooled specificity was 0.50. On patient-based analysis, the estimated sensitivity and specificity of FAPI were 0.96 and 0.96, and those of 18 F-FDG were 0.95 and 0.34, respectively. On lesion-based analysis, the estimated sensitivity and specificity of FAPI were 0.84 and 0.94, and those of 18 F-FDG were 0.86 and 0.78, respectively. On neck side-based analysis, the estimated sensitivity and specificity of FAPI were 0.88 and 0.79, and those of 18 F-FDG were 0.91 and 0.29, respectively.

Conclusions: Radiolabeled FAPI showed a good diagnostic performance for the detection of metastatic LN in HNC patients. Also, 18 F-FDG PET/CT revealed low specificity for LN staging in HNC patients. Future large multicenter research with more patients would be necessary to provide a more comprehensive overview of the usefulness of radiolabeled FAPI for LN staging in HNC patients.

Affiliations

Yun Seong Kim 1 2, Seong-Jang Kim 2 3 4
1Department of Internal Medicine.
2BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital.
3Department of Nuclear Medicine, Pusan National University School of Medicine.
4Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.