FAPI-04 PET/CT shows higher marginal uptake and central heterogeneity in hepatocellular carcinoma

A prospective trial evaluated the radioactive distribution patterns of [68Ga]Ga-FAPI-04 in 23 patients with primary hepatocellular carcinoma (26 lesions), compared with [18F]FDG PET/CT. The study setting and follow-up duration were not reported.

The main finding was that FAPI-04 uptake was significantly higher at tumor margins than at tumor centers (SUVmax, P <0.001; SUVmean, P <0.01). As SUVmax thresholds increased, the volume of interest for FAPI-04 concentrated at the tumor margins and decreased sharply in the centers. The study did not report specific effect sizes or absolute numbers for these comparisons.

Safety and tolerability data, including adverse events and discontinuations, were not reported. Key limitations of the evidence were not explicitly stated in the provided data. The practice relevance suggests that strong peripheral uptake could support the use of FAP-targeted fluorescence-guided surgery and targeted treatment of marginal residual or recurrent disease, while low central uptake may limit the effectiveness of FAP-targeted therapy for central tumor regions.