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Related Experiment Video

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An Automated Radiosynthesis of [68Ga]Ga-FAPI-46 for Routine Clinical Use
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Performance and Prospects of [68Ga]Ga-FAPI PET/CT Scans in Lung Cancer.

Paula E Borgonje1, Louise M Andrews1, Gerarda J M Herder2

  • 1Department of Clinical Pharmacy, Meander Medical Center, Maatweg 3, 3813 TZ Amersfoort, The Netherlands.

Cancers
|November 26, 2022
PubMed
Summary

Fibroblast activation protein imaging ([68Ga]Ga-FAPI PET/CT) shows high tumor uptake and specificity in lung cancer. This novel imaging agent demonstrates comparable or superior performance to [18F]FDG PET/CT, suggesting prognostic value.

Keywords:
CAFFAPIPET/CT[68Ga]Ga-FAPIfibroblast activation proteinlung cancer

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiochemistry

Background:

  • Fibroblast activation protein (FAP) is highly expressed in >90% of epithelial cancers, correlating with poor prognosis in lung cancer.
  • FAP-targeted radiotracers, like [68Ga]Ga-FAPI, offer high tumor specificity due to minimal expression in normal adult tissues.
  • FAPI's ability to bind FAP enables Gallium-68 labeling for PET/CT imaging and therapeutic radiopharmaceutical development.

Purpose of the Study:

  • To review the current applications and diagnostic performance of [68Ga]Ga-FAPI PET/CT in lung cancer.
  • To compare the efficacy of [68Ga]Ga-FAPI PET/CT with the established [18F]FDG PET/CT standard.
  • To explore the potential prognostic implications of [68Ga]Ga-FAPI PET/CT in lung cancer patients.

Main Methods:

  • Review of existing literature on [68Ga]Ga-FAPI PET/CT utilization in lung cancer.
  • Analysis of diagnostic performance metrics, including standardized uptake value (SUVmax) and tumor-to-background ratio (TBR).
  • Comparative assessment against [18F]FDG PET/CT in various lung cancer scenarios, including primary lesions and metastases.

Main Results:

  • [68Ga]Ga-FAPI PET/CT demonstrates high uptake and excellent tumor-to-background ratios in primary and metastatic lung cancer lesions.
  • Performance of [68Ga]Ga-FAPI PET/CT is comparable or superior to [18F]FDG PET/CT, particularly in detecting brain and bone metastases.
  • The imaging agent shows significant uptake in metastatic lesions from other cancer types within the lung.

Conclusions:

  • [68Ga]Ga-FAPI PET/CT is a highly specific and effective imaging modality for lung cancer, outperforming [18F]FDG PET/CT in certain metastatic settings.
  • The high tumor uptake and specificity suggest [68Ga]Ga-FAPI PET/CT's potential as a valuable diagnostic and prognostic tool in lung cancer management.
  • Further research into FAP-targeted therapies combined with [68Ga]Ga-FAPI imaging is warranted.