FAPI-PET/CT in Cancer Imaging: A Potential Novel Molecule of the Century

Rong Huang; Yu Pu; Shun Huang; Conghui Yang; Fake Yang; Yongzhu Pu; Jindan Li; Long Chen; Yunchao Huang

doi:10.3389/fonc.2022.854658

FAPI-PET/CT in Cancer Imaging: A Potential Novel Molecule of the Century

Front Oncol. 2022 May 25:12:854658. doi: 10.3389/fonc.2022.854658. eCollection 2022.

Authors

Rong Huang¹, Yu Pu², Shun Huang³, Conghui Yang¹, Fake Yang¹, Yongzhu Pu¹, Jindan Li¹, Long Chen^{1

2}, Yunchao Huang⁴

Affiliations

¹ Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China.
² Medical Imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China.
³ Department of Nuclear medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴ Department of Thoracic Surgery I, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China.

Abstract

Fibroblast activation protein (FAP), a type II transmembrane serine protease, is highly expressed in more than 90% of epithelial tumors and is closely associated with various tumor invasion, metastasis, and prognosis. Using FAP as a target, various FAP inhibitors (FAPIs) have been developed, most of which have nanomolar levels of FAP affinity and high selectivity and are used for positron emission tomography (PET) imaging of different tumors. We have conducted a systematic review of the available data; summarized the biological principles of FAPIs for PET imaging, the synthesis model, and metabolic characteristics of the radiotracer; and compared the respective values of FAPIs and the current mainstream tracer ¹⁸F-Fludeoxyglucose (¹⁸F-FDG) in the clinical management of tumor and non-tumor lesions. Available research evidence indicates that FAPIs are a molecular imaging tool complementary to ¹⁸F-FDG and are expected to be the new molecule of the century with better imaging effects than ¹⁸F-FDG in a variety of cancers, including gastrointestinal tumors, liver tumors, breast tumors, and nasopharyngeal carcinoma.

Keywords: 18 F-FDG; FAPI; Neoplasms; PET; fibroblast-activating protein; imaging.

Publication types

Review