A prospective multi-model study on comparative analysis of MRI with 18F-FAPI or 18F-FDG PET/CT to detect intestinal fibrosis in Crohn’s disease

Motivation: The accurate diagnosis of intestinal fibrosis is very important for CD management. Goal(s): The characterization of intestinal fibrosis by using non-invasive imaging techniques on intestinal lesions with various fibrosis and inflammation, to explore the optimal clinical applications for commonly used imaging techniques in clinical practice for fibrotic diagnosis, providing valuable insights for clinical decision-making. Approach: PET/CT and MTI were performed on animal and patient to investigate their efficiency on analyzation of intestinal fibrosis. Results: The diagnostic effect of 18F-FAPI PET/CT in detecting CD fibrosis surpasses that of 18F-FDG PET/CT, while comparable to MTI, and offers great potential in early detection of intestinal fibrosis. Impact: MTI is the most accurate technique for detecting intestinal fibrosis. 18F-FAPI PET/CT represents an optimal imaging technique currently, in terms of early fibrosis detection. However, its interpretation with fibrosis still requires caution due to the slight susceptibility to co-existing inflammation.