The Role of Fibroblast Activation Protein Ligands in Oncologic PET Imaging

Katharina Dendl1, Joel Schlittenhardt1, Fabian Staudinger1

  • 1Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg, Germany.

PET Clinics
|May 31, 2021
PubMed

Insights

Fibroblast activation protein inhibitors (FAPI) show promise as diagnostic and theranostic agents for various diseases. FAPI imaging may outperform current standards like fluorodeoxyglucose in oncology due to better tumor contrast.

Area of Science:

  • Oncology
  • Medical Imaging
  • Molecular Biology

Background:

  • Fibroblast activation protein (FAP) is increasingly recognized for its role in various pathologies.
  • FAP expression is notably high in tumor microenvironments.
  • Current diagnostic tracers have limitations in sensitivity and specificity.

Purpose of the Study:

  • To evaluate the potential of fibroblast activation protein inhibitors (FAPI) as diagnostic and theranostic agents.
  • To compare FAPI's performance against established oncological imaging tracers.
  • To explore FAPI's utility in both malignant and non-malignant conditions.

Main Methods:

  • Review of current literature on FAPI applications in medical imaging.
  • Analysis of FAPI's expression patterns in diverse disease states.
  • Comparison of FAPI imaging characteristics with fluorodeoxyglucose (FDG).

Main Results:

  • FAPI demonstrates selective expression in various pathologies, including a wide range of malignancies.
  • FAPI exhibits ligand-induced internalization, crucial for imaging and therapy.
  • Preliminary data suggest FAPI may be superior to FDG in certain oncological diseases, offering lower background activity and sharper tumor contrasts.

Conclusions:

  • FAPI represents a promising novel agent for diagnostic and potentially theranostic applications.
  • FAPI's characteristics suggest improved performance over current oncological tracers.
  • Further research is essential to fully understand FAP expression and FAPI's clinical utility.

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