AUTHOR=Quartuccio Natale , Nicolosi Stefania , Pulizzi Sabina , D’Oppido Dante , Ialuna Salvatore 

TITLE=The role of FAPI PET/CT in patients with lymphoma: a systematic review

JOURNAL=Frontiers in Nuclear Medicine

VOLUME=Volume 5 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/nuclear-medicine/articles/10.3389/fnume.2025.1589903

DOI=10.3389/fnume.2025.1589903

ISSN=2673-8880

ABSTRACT=IntroductionFluorodeoxyglucose (FDG) PET/CT is typically the reference imaging method for assessing and tracking lymphomas. However, fibroblast activation protein inhibitor (FAPI) PET is being explored as a potentially useful option, especially when Fluorodeoxyglucose (FDG) scans do not show clear results.MethodsFor this systematic review, two researchers searched PubMed/MEDLINE and Cochrane CENTRAL for studies on FAPI PET/CT in lymphoma patients.ResultsThe literature search initially retrieved 249 articles. After removing duplicates and screening titles and abstracts, and full text, there was a final selection of 15 articles (3 original studies and 12 case reports), encompassing a total of 270 patients. The three original studies were judged to have a low risk of bias according to the QUADAS-2 criteria. The systematic review reveals that FAPI PET/CT exhibits lower diagnostic sensitivity than [18F]FDG PET/CT in lymphomas characterized by low FAP expression. Nevertheless, FAPI PET/CT retains potential as a complementary imaging modality.Discussion[18F]FDG PET/CT remains the gold standard in lymphoma imaging, but FAPI PET/CT can potentially provide supplementary information regarding the molecular characteristics of lymphomas. FAPI PET/CT may have prognostic and therapeutic implications. In particular, it could help identify lymphoma subgroups with distinct stromal environments, potentially serving as a prognostic biomarker. Further large-scale prospective studies are warranted to validate its role in lymphoma management.