A study conducted at Aster International Institute of Oncology, Bengaluru, has found that FAPI PET/CT can detect the spread of ovarian cancer within the abdominal cavity more sensitively than conventional contrast-enhanced CT. Published in the Journal of Nuclear Medicine, the study highlights the potential of advanced molecular imaging to improve the assessment of ovarian cancer before surgery.
The findings could help clinicians evaluate the extent of cancer more accurately, assess whether surgery is feasible and plan appropriate treatment strategies. However, further research is needed to establish the technique’s role in routine clinical practice.
Study Compares FAPI PET/CT with Conventional CT
The prospective study evaluated 200 women with epithelial ovarian cancer. Researchers compared 68Ga-FAPI-04 PET/CT, commonly known as FAPI PET/CT, with conventional contrast-enhanced computed tomography (CT), using findings observed during surgery as the reference standard. The results showed that FAPI PET/CT achieved a sensitivity of 81.8% and diagnostic accuracy of 86%. In comparison, conventional CT recorded a sensitivity of 54.6% and diagnostic accuracy of 78%. These results indicate that FAPI PET/CT detected a greater proportion of cancer spread than conventional CT in the study population. It also demonstrated better sensitivity in identifying disease in the upper abdomen, where accurately mapping cancer deposits can be particularly important when planning surgery.
How FAPI PET/CT Helps Detect Ovarian Cancer Spread
FAPI PET/CT uses a radiotracer designed to target fibroblast activation protein (FAP), which is associated with activated fibroblasts in the tumour microenvironment. By highlighting these areas, the imaging technique can help make certain cancer deposits more visible on scans.
In ovarian cancer, the disease can spread across the peritoneum, the membrane lining the abdominal cavity and covering many abdominal organs. Therefore, determining the location and extent of these deposits before surgery is essential for assessing the feasibility of removing the visible disease. Compared with conventional imaging, FAPI PET/CT may provide additional information about the distribution of peritoneal disease. This could help multidisciplinary teams make better-informed decisions about surgical planning and overall treatment.
Advanced Imaging Could Support Preoperative Treatment Planning
Dr. Somashekhar S. P., Group Medical Director, Aster DM Quality Care, and Lead Consultant in Surgical and Gynaecological Oncology and Robotic Surgery at Aster Hospitals, Whitefield, said, “In advanced ovarian cancer, understanding the extent and distribution of peritoneal disease before surgery is critical to determining the most appropriate treatment strategy. Our study found that FAPI PET/CT was more sensitive than conventional CT in detecting peritoneal spread and provided a closer estimate of the overall disease burden compared with surgical findings.
“This approach could support more informed decisions around surgical feasibility and treatment planning. Further research will help establish its role across different clinical settings.” The findings highlight the importance of accurate preoperative imaging in ovarian cancer management. By identifying disease deposits that conventional CT may miss, FAPI PET/CT could provide clinicians with additional information when evaluating patients for surgery.
Nevertheless, imaging results must be interpreted alongside clinical assessments and other diagnostic findings. The study does not, by itself, establish that using FAPI PET/CT improves survival or other long-term patient outcomes.
Multidisciplinary Team Conducts the Study
The research was conducted between May 2024 and April 2025. The multidisciplinary team included specialists in nuclear medicine, surgical oncology, gynaecological oncology and robotic cancer surgery at Aster Whitefield Hospital.
The team members were:
Dr. Prathap H. J. — Head of Department, Nuclear Medicine, PET CT and Advanced Radioligand Theranostics.
Dr. Ashwin K. R. — Head of Department, Surgical Oncology, and Consultant in Surgical Oncology and Gynaecological Oncology.
Dr. Rohit Kumar C. — Consultant in Surgical Oncology and Robotic Cancer Surgery.
Dr. Esha R. Shanbhag — Consultant and Lead, Head of the Department of Gynaecologic Oncology.
The researchers noted that additional prospective studies are necessary to validate the results across different patient populations and treatment settings.
Further Research Needed to Establish Clinical Utility
The study adds to the growing evidence on the potential role of molecular imaging in ovarian cancer management. FAPI PET/CT demonstrated higher sensitivity and diagnostic accuracy than conventional contrast-enhanced CT in this study, particularly in assessing peritoneal disease. If further research confirms these findings, the technique could strengthen preoperative evaluation and help clinicians plan treatment more effectively. However, researchers must establish its performance across broader clinical settings and determine how best to integrate it into routine ovarian cancer care. As reported by pharmabiz.com, for now, FAPI PET/CT represents a promising imaging approach that may complement existing diagnostic methods and support more precise assessment of ovarian cancer spread.