(1) Background: Thyroid cancer (TC) is often treated with surgery followed by iodine-131. Up to 50% of the instances of TC lose their avidity to131I, becoming more aggressive. In this scenario, [18F]FDG PET/CT imaging is used for evaluating the widespread nature of the disease, despite its low sensitivity and a false negative rate of 8–21.1%. A novel class of PET agents targeting the fibroblast activation protein inhibitor (FAPi) has emerged, studied particularly for their potential application to theranostics. (2) Methods: A search of the literature was performed by two independent authors (P.G. and L.E.) using the PubMed, Scopus, Web of Science, Cochrane Library, and EMBASE databases. The following terms were used: “FAP” or “FAPi” or “Fibroblast activating protein” and “thyroid” or “thyroid cancer”, in different combinations. The included papers were original articles, clinical studies, and case reports in the English language. No time limits were used. Editorials, conference papers, reviews, and preclinical studies were excluded. (3) Results: There were 31 papers that were selected. Some studies reported a low or absent FAPi uptake in TC lesions; others reported promising findings for the detection of metastases. (4) Conclusions: The preliminary results are encouraging. FAPI agents are an alternative to [18F]FDG and a promising theranostic tool. However, further studies with a larger population are needed.
（1）背景：甲状腺癌（TC）通常采用手术联合碘-131治疗。高达50%的TC病例会丧失对131I的摄取能力，进而发展为更具侵袭性的类型。在此情况下，尽管[18F]FDG PET/CT成像的敏感性较低且假阴性率达8%-21.1%，仍被用于评估疾病的广泛程度。近年来，一类靶向成纤维细胞活化蛋白抑制剂（FAPi）的新型PET示踪剂逐渐兴起，其在诊疗一体化领域的应用潜力备受关注。 （2）方法：由两位独立研究者（P.G.与L.E.）系统检索PubMed、Scopus、Web of Science、Cochrane Library及EMBASE数据库。采用"FAP"、"FAPi"、"Fibroblast activating protein"与"thyroid"、"thyroid cancer"等关键词进行组合检索。纳入标准为英文发表的原创性研究、临床报告及病例分析，不设时间限制，排除社论、会议论文、综述及临床前研究。 （3）结果：共筛选出31篇文献。部分研究显示TC病灶对FAPi的摄取较低或缺失，另一些研究则提示其在转移灶检测方面具有潜在价值。 （4）结论：初步研究结果令人鼓舞。FAPI示踪剂可作为[18F]FDG的替代选择，是极具前景的诊疗一体化工具，但仍需开展更大样本量的深入研究加以验证。
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