ArticleEJNMMI research2026
Comparative evaluation of [¹⁸F]FAPI-42 and [¹⁸F]PSMA-1007 PET/CT for lesion detection and uptake in prostate cancer across disease stages.
Article in EJNMMI research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough [¹⁸F]PSMA-1007 enables sensitive detection in prostate cancer, heterogeneity in PSMA expression and variable physiologic uptake can limit performance, whereas [¹⁸F]FAPI-42, targeting fibroblast activation protein in tumor stroma and typically exhibiting low background, may improve conspicuity in regions affected by physiologic PSMA activity and in phenotypes with reduced PSMA expression. This study aimed to compare [¹⁸F]FAPI-42 and [¹⁸F]PSMA-1007 PET/CT in patients with prostate cancer, and assess lesion detection rates and uptake on [¹⁸F]FAPI-42 PET/CT across various disease stages.
resultsOf 759 lesions from 55 patients, 187 were PSMA-positive only, 72 were FAPI-positive only, and 500 were positive on both tracers. [¹⁸F]PSMA-1007 detected more lesions in newly diagnosed (233 vs. 181, P = 0.0001), biochemical recurrence (BCR) (67 vs. 56, P = 0.04), and castration-resistant prostate cancer(CRPC) (385 vs. 333, P < 0.0001) groups. [¹⁸F]PSMA-1007 also demonstrated higher SUV
conclusionWhile [¹⁸F]PSMA 1007 PET/CT remains superior for overall lesion detection, [¹⁸F]FAPI 42 PET/CT may provide complementary value in selected scenarios, particularly in subsets with reduced PSMA expression.
trial registrationChinese Clinical Trial Registry, ChiCTR2200063441. Registered 06 September 2022, https//www.chictr.org.cn/bin/project/edit? pid=149,714.
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