Fibroblast-activation protein inhibitors based positron emission tomography (PET) for assessing lung disease: A systematic review with meta-analysis.
Delong Huang, Qiaoli Zhao, Junhao Wu et al.
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In 30 seconds
This systematic review and meta-analysis assessed fibroblast-activation protein inhibitor (FAPI) PET/CT for diagnosing lung tumours and non-neoplastic lung lesions. The authors included 19 studies identified through searches up to 20 June 2024 and evaluated diagnostic accuracy using extracted patient data. For lung tumour detection, pooled sensitivity was 0.99 (95% CI: 0.90-1.00) and specificity was 0.82 (95% CI: 0.72-0.89). For non-neoplastic lesions, sensitivity was 0.93 (95% CI: 0.72-0.99) and specificity was 0.96 (95% CI: 0.79-0.99).
Key findings
- For lung tumour detection, pooled FAPI PET/CT sensitivity was 0.99 (95% CI: 0.90-1.00) and specificity was 0.82 (95% CI: 0.72-0.89).
- For non-neoplastic lesions, sensitivity was 0.93 (95% CI: 0.72-0.99) and specificity was 0.96 (95% CI: 0.79-0.99).
- In lung tumour staging (n = 397), sensitivity was 0.93 (95% CI: 0.83-0.97).
- For pneumonia, sensitivity was 0.80 (95% CI: 0.70-0.89) and specificity was 0.90 (95% CI: 0.84-0.96); sensitivity and specificity for idiopathic pulmonary fibrosis were reported as 1.00.
Why it matters
The pooled results suggest FAPI PET/CT may provide useful diagnostic information across both tumour and non-neoplastic lung conditions. Its reported performance in non-neoplastic disease is relevant because assessment of these conditions can be challenging. However, pooled accuracy estimates do not by themselves establish how the imaging method compares with existing approaches or whether its use improves patient outcomes.
What to keep in mind
The review included 19 studies, and the abstract does not report study-level sample sizes or follow-up. Estimates for specific non-neoplastic conditions may be based on limited evidence; the abstract does not provide their underlying study counts.