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August 16, 2026British Journal of Radiology

Comparison of 68Ga-FAPI PET/CT and 18F-FDG PET/CT in Gastric Cancer: Impact on Metastatic Detection and Stage Migration

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Authors

MOMerve OkuyanRecep Tayyip Erdoğan UniversityUEUmut ElboğaGaziantep UniversityEŞErtan ŞahinGaziantep University

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Overview

Retrospective study reveals superior metastatic detection with 68Ga-FAPI versus 18F-FDG PET/CT in gastric cancer, indicating improved tumor staging accuracy.

Key Points

  • To evaluate and compare the diagnostic performance of 68Ga-FAPI PET/CT versus 18F-FDG PET/CT for primary tumor uptake, metastatic lesion detection, and stage migration in gastric cancer.
  • Retrospectively analyzed 52 patients with histopathologically confirmed gastric cancer who underwent both 18F-FDG PET/CT and 68Ga-FAPI PET/CT imaging.
  • Assessed primary tumor uptake, SUVmax, tumor-to-background ratios, metastatic site detection (lymph node, peritoneal, liver, bone), and stage migration between modalities.
  • 68Ga-FAPI PET/CT exhibited significantly higher primary tumor uptake than 18F-FDG PET/CT (p < 0.001) and detected peritoneal metastases in 30.8% (16/52) versus 13.5% (7/52) of patients (p = 0.004).
  • Stage migration occurred in 25.0% (13/52) of patients between modalities, primarily driven by upstaging from newly detected metastatic disease with 68Ga-FAPI PET/CT.
  • 18F-FDG uptake was lower in signet-ring cell carcinoma subtypes, whereas 68Ga-FAPI uptake remained consistent regardless of histological subtype.

Cite This Study

Okuyan et al. (2026) studied this question.

synapsesocial.com/papers/6a8179cbf2fb91fc834ad342https://doi.org/10.1093/bjr/tqag185
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