FAPI PET as the workup for MCED positives
When a blood test says 'cancer signal, origin unclear', a FAPI PET scan may find it where FDG cannot.
Overview
When a blood test reports a cancer signal of unclear origin, this idea sends the patient for FAPI PET/CT rather than FDG PET as the first-line work-up. Many MCED-positive patients have no cancer found on standard imaging, which creates anxiety and cost, whereas FAPI PET is more sensitive than FDG in pancreatic, gastric, low-grade and peritoneal disease, exactly the cancers MCED promises to catch, and has low background in liver, brain and bowel. The test is a prospective diagnostic study nested in a Galleri deployment such as the NHS or a PATHFINDER-like cohort, randomising FDG versus FAPI PET. Speculative in maturity, it addresses the bottleneck The hardest cancers are found late and is linked from the ideas on a 28-day MCED-positive resolution pathway and whole-population interception.
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