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An Automated Radiosynthesis of [68Ga]Ga-FAPI-46 for Routine Clinical Use
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FAPI PET: Fibroblast Activation Protein Inhibitor Use in Oncologic and Nononcologic Disease

Yuriko Mori1, Katharina Dendl1, Jens Cardinale1

  • 1From the Department of Nuclear Medicine, Medical Faculty of Heinrich Heine University, University Hospital Düsseldorf, Düsseldorf, Germany (Y.M., K.D., J.C., F.L.G.); Department of Nuclear Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany (K.D., J.C., C.K., F.L.G., U.H.); and Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (F.L.G., U.H.).

Radiology
|January 3, 2023
PubMed

Insights

Gallium 68 (68Ga)-labeled fibroblast activation protein (FAP) inhibitor (FAPI) PET offers excellent imaging for detecting small lesions. This FAP imaging technique shows promise for early cancer diagnosis and potential theranostic applications.

Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiopharmaceutical Chemistry

Background:

  • Fibroblast Activation Protein (FAP) is highly expressed in cancer-associated fibroblasts within tumor stroma.
  • 68Ga-labeled FAP inhibitors (FAPI) target FAP for molecular imaging.
  • 68Ga-FAPI PET demonstrates rapid tracer uptake and low background, yielding superior imaging characteristics.

Purpose of the Study:

  • To review the current state of FAP imaging.
  • To summarize cancer biology relevant to FAP targeting.
  • To highlight recent clinical findings on 68Ga-FAPI PET and other FAPI tracers.

Main Methods:

  • Review of existing literature on FAP imaging and cancer biology.
  • Analysis of clinical data regarding the efficacy of 68Ga-FAPI PET.
  • Discussion of radiopharmaceutical development for FAP targeting.

Main Results:

  • 68Ga-FAPI PET enables detection of small primary and metastatic lesions, particularly in the brain, liver, pancreas, and gastrointestinal tract.
  • The DOTA chelator facilitates theranostic applications by enabling coupling with therapeutic radioisotopes like yttrium 90.
  • FAPI PET integrates well into clinical workflows, offering excellent imaging features.

Conclusions:

  • 68Ga-FAPI PET is a valuable tool for cancer imaging due to its high specificity and sensitivity.
  • The theranostic potential of FAPI tracers opens new avenues for personalized cancer treatment.
  • Continued research into FAP-targeted radiopharmaceuticals is crucial for advancing cancer diagnostics and therapeutics.

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