目的：最近的研究表明，68Ga-FAPI PET/CT在评估各种癌症类型，尤其是胃癌（GC）方面优于18F-FDG PET/CT。通过全面回顾与分析68Ga-FAPI和18F-FDG在GC中的差异，提供了一些证据来促进FAPI PET成像在临床应用中更广泛的应用。方法：本综述分析了截至2023年7月3日发表的使用放射性核素标记的FAPI作为PET在GC中进行诊断的研究。这些研究来自PubMed和Web of Science数据库。我们的统计分析包括诊断数据的双变量meta分析和定量指标的meta分析。这些分析使用R语言进行。结果：本次meta分析包括14项研究，共计527名患者，其中358名被诊断为GC。总体而言，68Ga-FAPI显示出更高的汇总敏感度（0.84 [95% CI 0.67-0.94] vs. 0.46 [95% CI 0.32-0.60]）、特异度（0.91 [95% CI 0.76-0.98] vs. 0.88 [95% CI 0.74-0.96]）和曲线下面积（AUC）（0.92 [95% CI 0.77-0.98] vs. 0.52 [95% CI 0.38-0.86]）比18F-FDG更高。数据表明，与18F-FDG相比，68Ga-FAPI PET在原发肿瘤、局部复发、淋巴结转移、远处转移和腹膜转移的敏感性上表现出更高的汇总敏感度。此外，68Ga-FAPI PET还提供了更高的最大标准摄取值（SUVmax）和肿瘤对背景比率（TBR）。对于骨转移而言，尽管68Ga-FAPI PET的患者为基础的汇总敏感度略低（0.93 vs. 1.00），但在病灶为基础的分析中，它在18F-FDG之上表现出显著优势（0.95 vs. 0.65）。然而，骨转移的SUVmax（均值差异MD 1.79 [95% CI -3.87-7.45]）和TBR（均值差异MD 5.01 [95% CI -0.78-10.80]）在68Ga-FAPI PET/CT和18F-FDG PET/CT之间没有显著差异。结论：与18F-FDG相比，68Ga-FAPI PET成像在评估GC的诊断准确性方面表现出改进。它在GC的早期诊断、初始分期和复发/转移的检测中可以有效应用。未来应用中，68Ga-FAPI可能有潜力取代18F-FDG在GC中的应用。（译文版权归原作者所有）

Purpose: Recent studies suggest that 68Ga-FAPI PET/CT demonstrated superiority over 18F-FDG PET/CT in the evaluation of various cancer types, especially in gastric cancer (GC). By comprehensively reviewing and analysing the differences between 68Ga-FAPI and 18F-FDG in GC, some evidence is provided to foster the broader clinical application of FAPI PET imaging. Methods: In this review, studies published up to July 3, 2023, that employed radionuclide labelled FAPI as a diagnostic radiotracer for PET in GC were analysed. These studies were sourced from both the PubMed and Web of Science databases. Our statistical analysis involved a bivariate meta-analysis of the diagnostic data and a meta-analysis of the quantitative metrics. These were performed using R language. Results: The meta-analysis included 14 studies, with 527 patients, of which 358 were diagnosed with GC. Overall, 68Ga-FAPI showed higher pooled sensitivity (0.84 [95% CI 0.67-0.94] vs. 0.46 [95% CI 0.32-0.60]), specificity (0.91 [95% CI 0.76-0.98] vs. 0.88 [95% CI 0.74-0.96]) and area under the curve (AUC) (0.92 [95% CI 0.77-0.98] vs. 0.52 [95% CI 0.38-0.86]) than 18F-FDG. The evidence showed superior pooled sensitivities of 68Ga-FAPI PET over 18F-FDG for primary tumours, local recurrence, lymph node metastases, distant metastases, and peritoneal metastases. Furthermore, 68Ga-FAPI PET provided higher maximum standardized uptake value (SUVmax) and tumour-to-background ratios (TBR). For bone metastases, while 68Ga-FAPI PET demonstrated slightly lower patient-based pooled sensitivity (0.93 vs. 1.00), it significantly outperformed 18F-FDG in the lesion-based analysis (0.95 vs. 0.65). However, SUVmax (mean difference [MD] 1.79 [95% CI -3.87-7.45]) and TBR (MD 5.01 [95% CI -0.78-10.80]) of bone metastases showed no significant difference between 68Ga-FAPI PET/CT and 18F-FDG PET/CT. Conclusion: Compared with 18F-FDG, 68Ga-FAPI PET imaging showed improved diagnostic accuracy in the evaluation of GC. It can be effectively applied to the early diagnosis, initial staging, and detection of recurrence/metastases of GC. 68Ga-FAPI may have the potential of replacing 18F-FDG in GC in future applications.© The author(s).