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. 2024 Feb 19;16(4):839. doi: 10.3390/cancers16040839

Table 2.

Principal characteristics of the discussed FAPi agents.

FAPi
Agents
FAPi Tracer Advantages Histotype Type of
Publication
Limitations
[68Ga]FAPi * Higher detection sensitivity in the liver, bones, and abdominal lymph nodes [40]; capable of localizing an abnormal foci of the uptake at the laryngeal mass, pulmonary nodules, the small nodule adjacent to the pulmonary hilum, which were previously ignored even in a non-contrast CT scan and an iodine scan [42]. PTC Interesting
image
[68Ga]Ga-FAPi uptake in mDTC lesions
is not clearly associated with Tg levels;
false positive
uptake of [68Ga]Ga-FAPi in myelofibrosis; reactive LNs; arthritis; subcutaneous fibroma [34,42]; thyroiditis [63]; pancreatitis; tuberculous lesions [53];
and low uptake in MTCs [17].
Capable of detecting primary thyroid diffuse large B-cell lymphoma due to the high degree of fibrosis (patient with previous Hashimoto’s thyroiditis) [53]. Hashimoto’s thyroiditis and primary thyroid diffuse large B-cell lymphoma Case report
Lower background value in liver, heart, brain, and gastrointestinal tract compared to [18F]FDG [68]. PTC
[18F]FAPi-42 Comparable diagnostic value with [18F]FDG; and a higher uptake, mainly in patients with a BRAFV600E gene mutation (prediction of mutation status) [35]. Different
histotypes
Comparison between [18F]FAPi-42 and [18F]FDG N.A.
[68Ga]FAPi-04
(otherwise named [68Ga]Ga-DOTA-FAPi-04)
Revealed more metastatic foci than [18F]FDG PET/CT, even if the detection rate rose to 93.1% when performed together [36]; and a higher detection power especially for lung lesions vs. [18F]FDG [39]. PTC Comparative study between [68Ga]FAPi-04 and [18F]FDG Diffuse uptake in chronic thyroiditis and immune-related thyroiditis [64,66] (confirmed also for [68Ga]Ga-FAPi-46 [62]) and also in follicular thyroid adenoma associated with fibrosis and calcification [65]; physiological uptake in myelofibrosis; reactive LNs; arthritis; and subcutaneous fibroma [34]. No statistical significance between the SUVmax of metastatic
lesions and Tg level [37]. Faint or absent uptake in lesions less than 1 cm in size or with low Tg levels [37].
Detected hepatic metastases, while [18F]FDG was negative (useful for restaging) [43]; and effective in evaluation of pleural metastasis and, therefore, in restaging [45]. PTC Interesting
image
Capable of evaluating immune-mediated disease with activated fibroblast such as Graves ophthalmopathy [67]. PTC Case report
More sensitive than [18F]FDG for neck and distant metastases; and [68Ga]FAPi SUVmax of metastasis is higher than that of [18F]FDG [34]. Different histotypes Comparative study between FAPi tracer and [18F]FDG
Detection rate of 87.5% in metastatic and RR lesions, mainly LNs and distant metastases such as lung, pleura, and bone [37]. Different histotypes of RR-DTC (22/24 PTC) Study on detection power of [68Ga]Ga-DOTA-FAPi-04
Able to detect bone metastases at an earlier time point compared to [18F]FDG [69]. Different histotypes Comparative studies
Robust detection accuracy in liver lesions; and higher tumor-to-background value compared to [68Ga]Ga-DOTA-TATE [51]. MTC Interesting
image
Higher detection power than that of [68Ga]Ga-DOTA-TOC [50]. Metastatic MTC Case report
[68Ga]Ga-DOTA.SA.FAPi Higher detection power than [18F]FDG PET/CT for lymph nodes, liver, brain, bowel, and lung metastases [38,52]. RR FCTC Comparative study between [68Ga]Ga-DOTA.SA.FAPi and [18F]FDG N.A.
[177Lu]Lu-DOTAGA.(SA.FAPi)2 Overall response rate of 92%, no grade III/IV hematological, renal, and hepatic toxicity [55]. RR-DTC Theranostic study N.A.
Partial response [58]. High-grade MTC Case report
Negligible radiotracer uptake in the liver and colon at post-treatment [177Lu]Lu-DOTAGA.Glu.(FAPi)2 scintigraphy [57]. MTC Comparative study between [177Lu]Lu-DOTAGA.(SA.FAPi)2 and [177Lu]Lu-DOTAGA.Glu.(FAPi)2
[177Lu]Lu-FAPi-46 Stable disease [56]. RR-DTC Interesting image N.A.

N.A.: not applicable; and *: the complete name of the molecule was not specified.