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However, rare report has been published using SPECT\/CT, a more available imaging method, with [<jats:sup>99m<\/jats:sup>Tc]Tc-labelled FAPI. In this study, we evaluated the potential effect of [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi in clinical analysis for digestive system tumours.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a single-centre prospective diagnostic efficiency study (Ethic approved No.: XJTU1AF2021LSK-021 of the First Affiliated Hospital of Xi\u2019an Jiaotong University and ChiCTR2100048093 of the Chinese Clinical Trial Register). Forty patients with suspected or confirmed digestive system tumours underwent [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi SPECT\/CT between January and June 2021. For dynamic biodistribution and dosimetry estimation, whole-body planar scintigraphy was performed at 10, 30, 90, 150, and 240\u00a0min post-injection in four representative patients. Optimal acquisition time was considered in all the patients at 60\u201390\u00a0min post-injection, then quantified or semi-quantified using SUV<jats:sub>max<\/jats:sub> and T\/B ratio was done. The diagnostic performance of [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi was calculated and compared with those of contrast-enhanced CT (ceCT) using McNemar test, and the changes of tumour stage and oncologic management were recorded.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Physiological distribution of [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi was observed in the liver, pancreas, gallbladder, and to a lesser extent in the kidneys, spleen and thyroid. Totally, 40 patients with 115 lesions were analysed. The diagnostic sensitivity of [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi for non-operative primary lesions was similar to that of ceCT (94.29% [33\/35] vs 100% [35\/35], respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.5); in local relapse detection, [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi was successfully detected in 100% (<jats:italic>n<\/jats:italic>\u2009=\u20093) of patients. In the diagnosis of suspected metastatic lesions, [<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi exhibited higher sensitivity (89.66% [26\/29] vs 68.97% [20\/29], respectively, <jats:italic>P<\/jats:italic>\u2009=\u20090.03) and specificity (97.9% [47\/48] vs 85.4% [41\/48], respectively,<jats:italic> P<\/jats:italic>\u2009=\u20090.03) than ceCT, especially with 100% (24\/24) specificity in the diagnosis of liver metastases, resulting in 20.0% (8\/40) changes in TNM stage and 15.0% (6\/40) changes in oncologic management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>[<jats:sup>99m<\/jats:sup>Tc]Tc-HFAPi demonstrates a greater diagnostic efficiency than ceCT in the detection of distant metastasis, especially in identifying liver metastases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-022-06068-1","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T05:03:05Z","timestamp":1670389385000},"page":"1228-1239","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["The role of [99mTc]Tc-HFAPi SPECT\/CT in patients with malignancies of digestive system: first clinical experience"],"prefix":"10.1007","volume":"50","author":[{"given":"Xi","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanbo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanglin","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huixing","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4841-5929","authenticated-orcid":false,"given":"Rui","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"issue":"2","key":"6068_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1038\/s41573-018-0004-1","volume":"18","author":"X Chen","year":"2019","unstructured":"Chen X, Song E. 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