Bengaluru: A newer imaging technique, FAPI PET/CT, could help doctors assess the spread of advanced ovarian cancer more accurately and plan surgery more effectively, according to a prospective study from Bengaluru.
The study, led by Dr. Prathap H J, HOD – Nuclear Medicine, PET CT and Advanced Radioligand Theranostics, Aster Whitefield Hospital, and published in the Journal of Nuclear Medicine, compared [68Ga]Ga-FAPI-04 PET/CT with conventional contrast-enhanced CT (CECT).
The study involved 200 women with epithelial ovarian cancer evaluated for cytoreductive surgery between May 2024 and April 2025. Researchers found that FAPI PET detected peritoneal disease with 81.8% sensitivity, compared with 54.6% for conventional CT, while overall diagnostic accuracy was 86% versus 78%.
FAPI PET showed a particularly notable advantage in detecting disease in difficult-to-assess areas such as the upper abdomen, small bowel and mesentery. The scan also provided a closer estimate of the cancer burden compared with findings during surgery.
Peritoneal spread is common in advanced ovarian cancer and can make complete removal of visible disease difficult. Accurate assessment before surgery may therefore help multidisciplinary teams decide whether a patient should undergo upfront cytoreductive surgery or receive chemotherapy before surgery.
However, the researchers stressed that FAPI PET is not a replacement for CT, surgery or clinical judgment. The study was conducted at a single centre, and most patients had received chemotherapy before imaging. Larger studies are needed to determine whether the technique can reduce non-beneficial surgeries and improve long-term patient outcomes.
For patients, the potential benefit of FAPI PET lies in providing a clearer picture of disease spread before a major operation, helping doctors choose a treatment approach based on the individual extent and location of cancer.
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