Can FAPI-PET imaging address unmet needs in nephro-urology?

Area of Science:

• Nuclear Medicine
• Oncology
• Nephrology

Background:

• Fibroblast activation protein (FAP) is upregulated in various cancers and benign conditions within the nephro-urological tract.
• Current imaging techniques and PET tracers face limitations due to nonspecific uptake and renal excretion, challenging diagnosis in nephro-urology.
• FAP-targeted PET offers potential to overcome these limitations, improving tumor detection and characterization.

Purpose of the Study:

• To review the biology of FAP expression in the nephro-urological system.
• To synthesize evidence on oncological and non-oncological applications of FAP-targeted PET in nephro-urology.
• To explore FAP-targeted PET's role in refining lesion characterization, guiding personalized management, and identifying theranostic opportunities.

Main Methods:

• Literature review of FAP biology and FAP-targeted PET applications in nephro-urology.
• Synthesis of emerging evidence from oncological and non-oncological studies.
• Focus on diagnostic and theranostic potential.

Main Results:

• FAP-targeted PET demonstrates promise in improving tumor detection and characterization compared to conventional imaging.
• Upregulated FAP expression in both malignant and benign nephro-urological conditions highlights broad applicability.
• Potential benefits include enhanced staging and response assessment for cancers and improved characterization of benign diseases.

Conclusions:

• FAP-targeted PET may serve as a valuable adjunct to current imaging strategies in nephro-urology.
• Its standalone clinical utility requires further validation through larger, prospective, disease-specific studies.
• Routine adoption necessitates confirmation of its efficacy and reliability in diverse nephro-urological settings.