A systematic review of [(68)Ga]Ga-DOTA-FAPI-04 and [(18)F]FDG PET/CT in the diagnostic value of malignant tumor bone metastasis

OBJECTIVE: This study aims to perform a systemic analysis of [(68)Ga]Ga-DOTA-FAPI-04 positron emission tomography (PET)/computerized tomography (CT) and [(18)F]FDG PET/CT for the diagnosis of malignant tumor bone metastasis based on existing clinical evidence. METHODS: This systematic review followed the guidelines of the Preferred Reporting Project (PRISMA) for systematic reviews and meta-analysis. This is a retrospective study of articles published in PubMed. Embase was searched online from the start of May 2022. The main endpoints were the maximum standardized uptake value and the tumor-to-background ratio to determine the examination performance of [68Ga]Ga-DOTA-FAPI-04 and [(18)F]FDG for bone transfer stoves. Based on the entry and discharge standards, two researchers extracted documents and data and then performed the quality evaluation. RESULTS: A total of eight studies on the metastasis of malignant tumors on bone were included, which involved 358 patients in the final analysis. CONCLUSION: [(68)Ga]Ga-DOTA-FAPI-04 showed better detection performance for bone metastasis. The sensitivity of [(68)Ga]Ga-DOTA-FAPI-04 for the diagnosis of the primary tumor was higher than that of [(18)F]FDG, whereas the specificity of [(18)F]FDG was higher than that of [(68)Ga]Ga-DOTA-FAPI-04. However, further randomized controlled trials and prospective clinical trials are warranted to compare the diagnostic performance of [(68)Ga]Ga-DOTA-FAPI-04 PET/CT and [(18)F]FDG PET/CT. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022313019)