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FAPI PET Better Identifies Disease in Ovarian Cancer
16 Sep
Summary
- FAPI PET shows higher sensitivity than CT for detecting peritoneal disease.
- Study found FAPI PET excels in challenging upper abdomen and small bowel.
- More accurate imaging could tailor ovarian cancer treatment sequences.
A prospective study conducted in Bengaluru between May 2024 and April 2025 has revealed that [68Ga]Ga-FAPI-04 PET/CT, known as FAPI PET, offers superior detection of peritoneal disease in women with ovarian cancer compared to conventional contrast-enhanced CT (CECT).
Peritoneal carcinomatosis, the spread of cancer to the abdominal lining, affects over 70% of ovarian cancer cases. Accurately mapping this spread is crucial for treatment planning, as deposits in areas like the bowel and mesentery can complicate surgical removal of all visible disease.
FAPI PET demonstrated an 81.8% sensitivity in detecting peritoneal disease, significantly higher than CECT's 54.6%. Its sensitivity was particularly notable in the upper abdomen (76.5% vs. 23.5% for CT) and small bowel/mesentery (50% vs. 31.3% for CT).
The study involved 200 women and compared imaging results against surgical findings. While CECT showed higher specificity, FAPI PET's estimates of disease burden were generally closer to surgical assessments.
Researchers suggest that FAPI PET's ability to target fibroblast activation protein (FAP) provides better contrast between tumor-associated tissue and normal tissue. This enhanced preoperative mapping may help multidisciplinary teams select appropriate treatment sequences, such as upfront cytoreductive surgery or neoadjuvant chemotherapy.
While promising, FAPI PET is not yet a replacement for existing methods. Further large-scale prospective studies are necessary to confirm its role and impact on patient outcomes, including potentially reducing non-therapeutic surgeries.
