Head-to-Head Comparison of Fibroblast Activation Protein Inhibitors (FAPI) Radiotracers versus [18F]F-FDG in Oncology: A Systematic Review

Giorgio Treglia; Barbara Muoio; Hessamoddin Roustaei; Zahra Kiamanesh; Kamran Aryana; Ramin Sadeghi

doi:10.3390/ijms222011192

Head-to-Head Comparison of Fibroblast Activation Protein Inhibitors (FAPI) Radiotracers versus [¹⁸F]F-FDG in Oncology: A Systematic Review

Int J Mol Sci. 2021 Oct 17;22(20):11192. doi: 10.3390/ijms222011192.

Authors

Giorgio Treglia^{1

2

3

4

5}, Barbara Muoio⁶, Hessamoddin Roustaei⁷, Zahra Kiamanesh⁷, Kamran Aryana⁷, Ramin Sadeghi⁷

Affiliations

¹ Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
² Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, 1011 Lausanne, Switzerland.
³ Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
⁴ Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland.
⁵ Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland.
⁶ Department of Medicine and Oncology, Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
⁷ Nuclear Medicine Research Center, Mashhad University of Medical Sciences, 9919991766 Mashhad, Iran.

Abstract

Several recent studies comparing radiolabeled fibroblast activation protein inhibitors (FAPI) and fluorine-18 fluorodeoxyglucose ([¹⁸F]F-FDG) as positron emission tomography (PET) radiotracers in oncology have been published. The aim of this systematic review is to perform an updated evidence-based summary about the comparison of these PET radiotracers in oncology to better address further research in this setting. Studies or subsets of studies comparing radiolabeled FAPI and [¹⁸F]F-FDG as PET radiotracers in oncology were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until August 2021. Literature data about the comparison of [¹⁸F]F-FDG and radiolabeled FAPI are rapidly increasing. Overall, taking into account radiotracer uptake and tumor-to-background uptake ratio, compared to [¹⁸F]F-FDG PET, an equal or higher detection of primary tumors and/or metastatic lesions was usually demonstrated by using radiolabeled FAPI PET. In particular, the cancer entities with better detection rate of tumor lesions by using radiolabeled FAPI PET, compared to [¹⁸F]F-FDG PET, were gastrointestinal tumors, liver tumors, breast cancer and nasopharyngeal carcinoma. Further comparison studies are needed to better evaluate the best field of application of radiolabeled FAPI PET.

Keywords: FAPI; FDG; PET; cancer; fibroblast activation protein; fluorodeoxyglucose; imaging; oncology; positron emission tomography; systematic review.

Publication types

Comparative Study
Systematic Review

MeSH terms

Endopeptidases
Fluorodeoxyglucose F18*
Gallium Radioisotopes
Heterocyclic Compounds, 1-Ring / chemistry
Heterocyclic Compounds, 1-Ring / pharmacology*
Humans
Medical Oncology
Membrane Proteins / antagonists & inhibitors*
Neoplasms / diagnostic imaging*
Positron Emission Tomography Computed Tomography / methods*

Substances

Gallium Radioisotopes
Heterocyclic Compounds, 1-Ring
Membrane Proteins
Fluorodeoxyglucose F18
1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid
Gallium-68
Endopeptidases
fibroblast activation protein alpha