A group of Bengaluru doctors found that a newer imaging technique using Fibroblast Activation Protein Inhibitor (FAPI) can detect the spread of ovarian cancer within the abdomen more accurately than conventional contrast-enhanced computed tomography (CT) scans. The prospective study, involving 200 women with ovarian cancer, was published in the Journal of Nuclear Medicine. The findings suggest that FAPI PET/CT could help doctors assess the extent of cancer spread more accurately and make better-informed treatment decisions.
Detecting Peritoneal Spread in Ovarian Cancer
Peritoneal spread occurs when cancer cells spread across the lining of the abdominal cavity. It is common in advanced ovarian cancer and plays a critical role in determining whether a patient is suitable for surgery. However, conventional imaging techniques can miss small or flat cancer deposits, particularly around the bowel and upper abdomen. Consequently, doctors may underestimate the extent of the disease, making treatment planning more challenging. Accurately mapping cancer spread helps clinicians determine whether patients should undergo cytoreductive surgery to remove visible tumours or receive chemotherapy before surgery.
Study Compares FAPI PET/CT with Contrast-Enhanced CT
Researchers conducted the study at Aster International Institute of Oncology in Bengaluru between May 2024 and April 2025. They compared gallium-68 FAPI-04 PET/CT (⁶⁸Ga-FAPI-04 PET/CT) with contrast-enhanced CT scans in 200 patients before cytoreductive surgery. The research team compared the imaging results with the findings recorded during surgery, which served as the reference standard. This approach enabled the researchers to evaluate how accurately each imaging technique identified peritoneal cancer deposits.
FAPI PET/CT Shows Higher Sensitivity and Accuracy
The study found that FAPI PET/CT outperformed conventional CT in detecting peritoneal disease.
Key findings included:
Sensitivity: FAPI PET/CT achieved 81.8%, compared with 54.6% for contrast-enhanced CT.
Overall accuracy: FAPI PET/CT recorded 86%, compared with 78% for CT.
Assessment of disease extent: CT tended to underestimate the amount of cancer spread within the abdomen.
These results indicate that FAPI PET/CT may help doctors identify cancer deposits that conventional CT scans could overlook.
FAPI PET/CT Provides a Better Assessment of Tumour Burden
The researchers also compared the Peritoneal Cancer Index (PCI), a scoring system used to assess the extent of cancer spread across different regions of the abdomen. The average PCI score measured during surgery was 15.7. In comparison, FAPI PET/CT recorded an average score of 14.1, while conventional CT recorded 10.8. The difference suggests that FAPI PET/CT assessed the extent of peritoneal disease more closely to the surgical findings than conventional CT. By providing a more comprehensive picture of tumour distribution, the technique could help clinicians evaluate disease burden before surgery.
Implications for Ovarian Cancer Treatment Planning
Accurate preoperative imaging is essential for planning ovarian cancer treatment, particularly when doctors consider cytoreductive surgery. By improving the detection of peritoneal deposits, FAPI PET/CT could help clinicians assess surgical suitability and determine the most appropriate treatment sequence. Although the findings are promising, further research may help establish the technique’s role in routine clinical practice and clarify how its use affects surgical planning and patient outcomes. As reported by thetimesofindia.indiatimes.com, the study highlights the potential of FAPI PET/CT to improve the assessment of abdominal cancer spread and support more informed treatment decisions for women with ovarian cancer.