Abstract
Relevance: Positron emission tomography (PET) imaging is a key tool for diagnosing, staging, and monitoring malignant tumors. However, the widely used radiopharmaceutical 18F-FDG has limited specificity due to its high uptake in inflammatory and metabolically active tissues. This has led to increased interest in new radiopharmaceuticals, such as 18F-FAPI, which demonstrate high potential for the visualization of malignant tumors.The study aimed to analyze current data on the use of 18F-FAPI in PET imaging of malignant tumors, including comparison with 18F-FDG and up-to-date information on oncological diagnostics in Kazakhstan.Materials and Methods: A review of preclinical and clinical studies on the diagnostic capabilities of 18F-FAPI for various cancer types was conducted. A comparative analysis of the effectiveness of 18F-FAPI and 18F-FDG in gastric, liver, and pancreatic tumors was performed. Epidemiological data and PET diagnostic indicators in Kazakhstan were also summarized.Results: The reviewed studies demonstrate high sensitivity and specificity of 18F-FAPI in detecting tumors with a pronounced stromal component, as well as its advantage over 18F-FDG in low-glycolytic tumors. Improved visualization of primary lesions and metastases (including lymph nodes, peritoneum, and lungs) has been shown in several gastrointestinal malignancies. Preclinical data confirm selective tracer accumulation and a favorable safety profile. Epidemiological indicators in Kazakhstan highlight the need for more accurate molecular imaging methods.Conclusion: 18F-FAPI has substantial potential to improve the diagnostic accuracy of PET imaging across various malignant neoplasms, particularly in cases where 18F-FDG provides limited information. Its use may enhance early detection, staging, and assessment of treatment response, making this radiopharmaceutical a promising tool in modern oncologic diagnostics.