PET/CT FAPI: Procedure and evidence review in oncology

Area of Science:

• Oncology
• Radiopharmaceuticals
• Molecular Imaging

Background:

• Neoplasms comprise malignant cells within a microenvironment (tumor stroma).
• The tumor microenvironment is crucial for cancer progression, including proliferation, invasion, angiogenesis, and migration.
• Fibroblast activation protein (FAP) is overexpressed in activated cancer-associated fibroblasts (CAFs) and linked to poor prognosis.

Purpose of the Study:

• To educate on the procedure for performing Positron Emission Tomography/Computed Tomography (PET/CT) using FAPI radiopharmaceuticals.
• To describe the biodistribution of FAPI radiopharmaceuticals.
• To outline the current and potential clinical applications of FAPI PET/CT in oncology.

Main Methods:

• Utilizing FAPI radiopharmaceuticals for PET/CT imaging.
• Assessing the density of fibroblast activation protein (FAP) on cancer-associated fibroblasts (CAFs).
• Detailing the PET/CT FAPI procedure and biodistribution analysis.

Main Results:

• FAPI radiopharmaceuticals effectively target FAP, which is overexpressed in CAFs.
• The presence of FAP is associated with poor prognostic outcomes in cancer patients.
• This imaging modality demonstrates significant potential for clinical applications in oncology.

Conclusions:

• FAPI PET/CT imaging represents a novel approach to visualize and quantify FAP expression in the tumor microenvironment.
• Understanding FAP density via FAPI PET/CT can provide valuable prognostic information.
• FAPI radiopharmaceuticals hold promise for advancing oncological diagnostics and treatment strategies.