FAPI PET/CT Outperforms FDG for Hepatopancreatobiliary Cancer Detection in Large Real-World Study

FAPI PET/CT showed 93.0% sensitivity vs 76.5% for FDG (p=0.002) in 176 patients with suspected HPB cancers. Nodal accuracy was 86.8% vs 71.1%. Dual-tracer approach did not improve accuracy. Prospective validation needed.

• Primary tumor accuracy: FAPI 78.9% vs FDG 68.3% (p=0.021); dual-tracer (76.7%) did not outperform FAPI alone (p=0.711).
• Nodal accuracy favored FAPI (86.8% vs 71.1%, p=0.004), due to higher specificity; distant metastasis detection was not significantly different (83.9% vs 80.0%, p=0.625).
• Limitation: retrospective single-center design; results require confirmation in prospective studies.

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