ArticleBMC medical imaging2026
The diagnostic value of ⁶⁸Ga-FAPI PET/CT in patients with suspicious recurrent or metastatic differentiated thyroid cancer: a comparative study.
Article in BMC medical imaging, 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
objectiveThis study aimed to compare the detection rates and uptake values of gallium-68 (⁶⁸Ga)-labeled fibroblast activation protein inhibitor (FAPI) PET/CT with those of fluorine-18 (¹⁸F)- labeled fluorodeoxyglucose (FDG) PET/CT in patients with suspicious recurrent or metastatic differentiated thyroid cancer (DTC), and to explore the association of these rates and values with diverse clinical-pathological characteristics and degrees of differentiation based on visual analysis and semi-quantitative parameters.
methodsA retrospective cohort comprising 56 patients with elevated Tg, positive anti-Tg antibodies, or thyroid ultrasound suggesting recurrence or metastasis was enrolled. All patients had previously undergone ⁶⁸Ga-FAPI PET/CT and ¹⁸F-FDG PET/CT scans. Lesion detection and uptake values were analyzed visually and semi-quantitatively, with final diagnosis confirmed by histopathology or clinical follow-up.
results¹⁸F-FDG PET/CT identified more positive patients (86% vs. 76%) and demonstrated a higher detection rate in lymph node metastases (71% vs. 59%, p=0.029). ⁶⁸Ga-FAPI showed higher uptake (SUVmax) in pulmonary metastases (3.31 vs. 1.74, p=0.017) but a lower tumor-to-background ratio (TBR) in lymph nodes (2.20 vs. 4.10, p<0.001). Among the clinical and pathological characteristics assessed, Tg levels, short axis diameter (SAD) of lymph node, and iodine uptake displayed significant differences between ⁶⁸Ga-FAPI uptake negative (FAPI-) and ⁶⁸Ga-FAPI uptake positive (FAPI+) groups (p=0.025, p<0.001, p=0.003). However, only the SAD of lymph node showed a moderate positive correlation with the SUVmax value of ⁶⁸Ga-FAPI in the lesion (r=0.393, p=0.042).
conclusionOur findings indicate that ⁶⁸Ga-FAPI PET/CT does not demonstrate significantly superior diagnostic performance when compared to ¹⁸F-FDG PET/CT in patients with recurrent or metastatic DTC. Nevertheless, for patients with enlarged metastatic lymph nodes, elevated Tg levels, and iodine-affinity lesions, ⁶⁸Ga-FAPI PET/CT could represent a valuable diagnostic tool.
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