旨在评估成纤维细胞活化蛋白抑制剂 (FAPI) PET/CT 在检测肺癌患者淋巴结 (LN) 转移方面的诊断性能。检索了 PubMed 和 Embase 数据库以识别截至 2024 年 7 月发表的相关文章。我们纳入了研究报告 FAPI PET/CT 在检测肺癌患者淋巴结转移方面的诊断准确性。在现有研究中对 FAPI PET/CT 和氟脱氧葡萄糖 (FDG) PET/CT 进行了头对头比较。使用双变量随机效应模型确定汇总的敏感性、特异性和受试者工作特征曲线下面积 (AUC)。涉及 409 名患者的七项研究符合资格。 FAPI PET/CT 检测肺癌患者淋巴结转移的汇总敏感性、特异性和 AUC 值分别为 88%（95% CI，78-93%）、94%（95% CI，89-96%）和分别为 0.97（95% CI，0.95-0.98）。六项研究提供了头对头比较数据，汇总的敏感性、特异性和 AUC 值分别为 89% (95% CI 80-95%)、94% (95% CI 89-97%) 和 0.97 (95 FAPI PET/CT 的百分比 CI 0.95-0.98)，而 FDG PET/CT 的百分比 CI 为 78% (95% CI 64-87%)、66% (95% CI 33-88%) 和 0.80 (95% CI 0.76-0.83) CT。 Fagan 列线图表明，当检测前概率设置为 26% 时，FAPI PET/CT 扫描的检测后阴性概率可降至 4%。FAPI PET/CT 在检测淋巴结转移方面显示出出色的诊断准确性。肺癌患者，优于标准护理 FDG PET/CT。 FAPI PET/CT 对淋巴结转移的出色排除性能表明它具有减少侵入性诊断程序的潜力。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

To evaluate the diagnostic performance of fibroblast activation protein inhibitors (FAPI) PET/CT for the detection of lymph node (LN) metastases in lung cancer patients.The PubMed and Embase databases were searched to identify relevant articles published through July 2024. We included studies reporting the diagnostic accuracy of FAPI PET/CT in detecting LN metastases in lung cancer patients. A head-to-head comparison of FAPI PET/CT and fluorodeoxyglucose (FDG) PET/CT was made among available studies. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristics curve (AUC) were determined by using bivariate random-effects model.Seven studies with 409 patients were eligible. The pooled sensitivity, specificity, and AUC value for FAPI PET/CT in detecting LN metastases in lung cancer patients were 88% (95% CI, 78-93%), 94% (95% CI, 89-96%), and 0.97 (95% CI, 0.95-0.98), respectively. Six studies provided head-to-head comparison data, and the pooled sensitivity, specificity, and AUC value were 89% (95% CI 80-95%), 94% (95% CI 89-97%), and 0.97 (95% CI 0.95-0.98) for FAPI PET/CT versus 78% (95% CI 64-87%), 66% (95% CI 33-88%), and 0.80 (95% CI 0.76-0.83) for FDG PET/CT. Fagan nomogram indicated that when the pre-test probability was set at 26%, the negative post-test probability for a FAPI PET/CT scan could decrease to 4%.FAPI PET/CT shows excellent diagnostic accuracy for the detection of LN metastases in lung cancer patients, and is superior to standard-of-care FDG PET/CT. The outstanding ruling-out performance of FAPI PET/CT for LN metastases indicates that it holds the potential to reduce invasive diagnostic procedures.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.