Skip to main content
. 2020 Sep 15;12(9):2629. doi: 10.3390/cancers12092629

Table 1.

Summary of studies on FAP-specific PET in cancer patients. COI: Conflict of Interest.

Title Author Year Tumor (Patients) Tracer (Patients) Key Findings COI Funding
68Ga-NOTA-FAPI-04 PET/CT in a patient with primary gastric diffuse large B cell lymphoma: comparisons with [(18)F] FDG PET/CT Wang et al. [22] 2020

  • Gastric diffuse large B cell lymphoma (1 patient)

  • 68Ga- FAPI-04 (1 patient)

  • FAP-specific PET showed considerable uptake in the primary gastric lymphoma and less uptake in regional lymph nodes compared to FDG

 none Beijing Municipal Science & Technology Commission
Fibroblast Activation Protein (FAP) specific PET for advanced target volume delineation in Glioblastoma Windisch et al. [23]
* same patient collective as Röhrich et al.		 2020

  • Glioblastoma (13 patients)

  • 68Ga-FAPI-02 (2 patients)

  • 68Ga-FAPI-04 (11 patients)

  • Using an SUV threshold of 7-fold the background in healthy brain tissue as a threshold, resulted in tumor volumes equal to that on T1-weighted contrast-enhanced MRI

  • Radiotherapy target volumes based on MRI and FAP-specific PET were incongruent

 Patent application none
FAPI-74 PET/CT Using Either 18F-AlF or Cold-kit 68Ga-labeling: Biodistribution, Radiation Dosimetry and Tumor Delineation in Lung Cancer Patients Giesel, Adeberg et al. [24] 2020

  • Non small cell lung cancer (10 patients)

  • Adenocarcinoma (8 patients)

  • Squamous cell carcinoma (2 patients)

  • 18F-FAPI-74 (10 patients)

  • No difference between adenocarcinoma and SCC

  • Lower radiation burden compared to 18F-FDG

  • Best correlation to CT-based target volumes occurred at an SUV of 3-fold the background

 Patent application, Shares in Consultancy group none
Usefulness of [68Ga] Ga-DOTA-FAPI-04 PET/CT in patients presenting with inconclusive [18F] FDG PET/CT findings Chen et al. [25] 2020

  • Gastric cancer (12 patients)

  • Signet ring cell carcinoma (4 patients)

  • Adenocarcinoma (8 patients)

  • Non small cell lung cancer (10 patients)

  • Adenocarcinoma (10 patients)

  • Small cell lung cancer (1 patient)

  • Liver cancer (9 patients)

  • Hepatocellular carcinoma (5 patients)

  • Intrahepatic cholangiocarcinoma (4 patients)

  • Nasopharyngeal cancer (7 patients)

  • c (7 patients)

  • Esophageal cancer (4 patients)

  • Squamous cell carcinoma (4 patients)

  • Breast cancer (4 patients)

  • Invasive ductal carcinoma (3 patients)

  • Invasive lobular carcinoma (1 patient)

  • Cholangiocarcinoma (4 patients)

  • Adenocarcinoma (4 patients)

  • Ovarian cancer (2 patients)

  • High-grade serous adenocarcinoma (2 patients)

  • Cancer of unknown primary (2 patients)

  • Squamous cell carcinoma (2 patients)

  • Pancreatic cancer (1 patient)

  • Adenocarcinoma (1 patient)

  • Cervical cancer (1 patient)

  • Squamous cell carcinoma (1 patient)

  • Renal cancer (1 patient)

  • Clear cell carcinoma (1 patient)

  • Appendiceal carcinoma (1 patient)

  • Mucinous adenocarcinoma (1 patient)

  • 68Ga-FAPI-04 (59 patients)

  • Lower absolute signal of FAP-specific PET for brain metastases but higher tumor-to-background ratio compared to FDG

  • FAP-specific PET identified more lesions than FDG-PET especially in peritoneal carcinomatosis, liver and skeletal metastases that in some cases lead to changes to staging and treatment

  • Good tumor-to background ratio of FAP-specific PET in liver and gastric cancer

  • The value of FAP-specific PET for differentiation of benign from malignant lesions requires further investigation due to possible false positives associated with inflammation-induced fibrosis

 none National Natural Science Foundation of China
Fibroblast imaging of hepatic carcinoma with 68Ga-FAPI-04 PET/CT: a pilot study in patients with suspected hepatic nodules. Shi et al. [26] 2020

  • Liver cancer (13 patients)

  • Hepatocellular carcinoma (11 patients)

  • Intrahepatic cholangiocarcinoma (2 patients)

  • Gastric cancer (1 patient, liver metastases)

  • Adenocarcinoma (1 patient)

  • Breast cancer (1 patient, liver metastases)

  • Sigmoid carcinoma (1 patient, liver metastases)

  • Adenocarcinoma (1 patient)

  • 68Ga-FAPI-04 (16 patients)

  • High sensitivity of FAP-specific PET for detection of HCC and ICC

  • Hepatic uptake was correlated with cirrhosis and hepatitis

 none National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, CAMS Innovation Fund for Medical Sciences
68Ga-FAPI PET/CT Detects Gastric Signet-Ring Cell Carcinoma in a Patient Previously Treated for Prostate Cancer Pang et al. [27] 2020

  • Gastric cancer (1 patient)

  • Signet ring cell carcinoma (1 patient)

  • Not specified (1 patient)

  • FAP-specific PET visualized the primary tumor and metastases

  • Tracer uptake also occurred in both adrenal glands

 none none
Fibroblast activation protein inhibitor (FAPI) PET for diagnostics and advanced targeted radiotherapy in head and neck cancers Syed et al. [8] 2020

  • Head and neck (14 patients)

  • Squamous cell carcinoma (12 patients)

  • Mucoepidermoid carcinoma (1 patient)

  • Undifferentiated (1 patient)

  • Not specified (14 patients)

  • Using an SUV of 5-fold the threshold resulted in tumor volumes most similar to CT

  • Tumor volumes based on FAP-specific PET and CT were incongruent and in some cases GTVs based on FAP-specific PET were not covered by PTVs based on CT

 Patent application, Shares in Consultancy group Open Access funding provided by Projekt DEAL
Comparison of 68Ga-FAPI and 18F-FDG PET/CT in a Patient With Cholangiocellular Carcinoma: A Case Report Pang et al. [28] 2020

  • Cholangiocarcinoma (1 patient)

  • Not specified (1 patient)

  • FAP-specific PET detected more metastatic lesions than FDG PET in one patient with cholangiocarcinoma

 none none
FAP-specific PET signaling shows a moderately positive correlation with relative CBV and no correlation with ADC in 13 IDH wildtype glioblastomas Röhrich et al. [11]
* same patient collective as Windisch et al.		 2020

  • Glioblastoma (13 patients)

  • 68Ga-FAPI-02 (2 patients)

  • 68Ga-FAPI-04 (11 patients)

  • ∙

  • Intensity of FAP-specific PET in glioblastoma does most likely not reflect cell density but expression of FAP

  • Intensity of FAP-specific PET does not solely reflect perfusion but is not completely independent from perfusion either

 Patent application Federal Ministry of Education and Research
Comparison of [68Ga] Ga-DOTA-FAPI-04 and [18F] FDG PET/CT for the diagnosis of primary and metastatic lesions in patients with various types of cancer Chen et al. [12] 2020

  • Non small cell lung cancer (12 patients)

  • Adenocarcinoma (11 patients)

  • Adenosquamous carcinoma (1 patient)

  • Small cell lung cancer (2 patients)

  • Liver cancer (11 patients)

  • Hepatocellular carcinoma (6 patients)

  • Intrahepatic cholangiocarcinoma (5 patients)

  • Nasopharyngeal cancer (7 patients)

  • Nonkeratinizing, undifferentiated carcinoma (7 patients)

  • Gastric cancer (8 patients)

  • Adenocarcinoma (7 patients)

  • Signet ring cell carcinoma (1 patient)

  • Pancreatic cancer (4 patients)

  • Adenocarcinoma (3 patients)

  • Adenosquamous carcinoma (1 patient)

  • Esophageal cancer (5 patients)

  • Squamous cell carcinoma (5 patients)

  • Glioma (4 patients)

  • Glioblastoma (2 patients)

  • Grade II glioma (1 patient)

  • Grade III glioma (1 patient)

  • Ovarian cancer (6 patients)

  • High-grade serous carcinoma (6 patients)

  • Colorectal cancer (8 patients)

  • Adenocarcinoma (8 patients)

  • Cervical cancer 3 patients)

  • Squamous cell carcinoma (3 patients)

  • Sarcoma (3 patients)

  • Osteosarcoma (1 patient)

  • Hemangiosarcoma (1 patient)

  • Liposarcoma (1 patient)

  • Neuroendocrine tumor (3 patients)

  • G2 (1 patient)

  • G3 (2 patients)

  • Breast cancer (1 patient)

  • Invasive ductal carcinoma (1 patient)

  • 68Ga-FAPI-04 (75 patients)

  • FAP-specific PET showed particular good tumor-to-background ratios compared to FDG for hepatic and peritoneal tumor manifestations

  • FAP-specific PET showed higher sensitivity in the detection of lymphonodal, osseous and visceral metastases with no difference in specificity

 none National Natural Science Foundation of China
68Ga-FAPI PET/CT Improves Therapeutic Strategy by Detecting a Second Primary Malignancy in a Patient With Rectal Cancer. Chen et al. [29] 2020

  • Rectal cancer (1 patient)

  • Non small cell lung cancer (1 patient)

  • Adenocarcinoma (1 patient)

  • Not specified (1 patient)

  • FAP-specific PET was successfully used for biopsy planning in a lung node that had moderate uptake on FDG PET

 none none
The role of FAPI-PET/CT for patients with malignancies of the lower gastrointestinal tract - first clinical experience Koerber et al. [30] 2020

  • Anal cancer (7 patients)

  • Rectal cancer (4 patients)

  • Sigmoid cancer (6 patients)

  • Colon cancer (5 patients)

  • 68Ga-FAPI-04 (16 patients)

  • 68Ga-FAPI-46 (6 patients)

  • FAP-specific PET changed the classification according to TNM in 50% of treatment naïve patients

  • FAP-specific PET caused a change in the (radio)oncological management in 81% of patients

 Patent application none
Intense FAPI Uptake in Inflammation May Mask the Tumor Activity of Pancreatic Cancer in 68Ga-FAPI PET/CT Luo et al. [31] 2020

  • Pancreatic cancer (1 patient)

  • Not specified (1 patient)

  • FAP-specific PET, unlike FDG-PET, did not delineate a mass that turned out to be pancreatic cancer most likely due to surrounding, tumor-induced pancreatitis

 none CAMS Initiative for Innovative Medicine
Radiation dosimetry and biodistribution of 68Ga-FAPI-46 PET imaging in cancer patients Meyer et al. [32] 2019

  • Breast cancer (1 patient)

  • Gastric cancer (1 patient)

  • Head and neck cancer (1 patient)

  • Oropharynx carcinoma (1 patient)

  • Pancreatic cancer (1 patient)

  • Cholangiocarcinoma (1 patient)

  • 68Ga-FAPI-46 (6 patients)

  • FAP-specific PET showed high tumor-to-background ratios that increased over the three timepoints

 Patent application none
Positive FAPI-PET/CT in a metastatic castration-resistant prostate cancer patient with PSMA-negative/FDG-positive disease Khreish et al. [33] 2019

  • Prostate cancer (1 patient)

  • 68Ga- FAPI-04 (1 patient)

  • FAP-specific PET showed intense uptake of all metastases of a patient with dedifferentiated, advanced-stage prostate cancer

 Patent application none
IDH-wildtype glioblastomas and grade III/IV IDH-mutant gliomas show elevated tracer uptake in fibroblast activation protein-specific PET/CT Röhrich et al. [34]
* same patient collective as Windisch et al.		 2019

  • Glioma (18 patients)

  • Grade II glioma (3 patients)

  • Grade III glioma (1 patient)

  • Glioblastoma (14 patients)

  • 68Ga-FAPI-02 (2 patients)

  • 68Ga-FAPI-04 (16 patients)

  • FAP-specific PET showed high tracer accumulation in grade III/IV but not grade II gliomas

 none Federal Ministry of Education and Research
FAPI-PET/CT improves staging in a lung cancer patient with cerebral metastasis Giesel et al. [35] 2019

  • Non small cell lung cancer (1 patient)

  • Adenocarcinoma (1 patient)

  • 68Ga- FAPI-04 (1 patient)

  • FAP-specific PET detected two brain metastases (>= 8 mm)

 Patent application
68Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer. Kratochwil et al. [36] 2019

  • Renal cancer (1 lesion)

  • Insulinoma (1 lesion)

  • Prostate cancer (16 lesions)

  • Neuroendocrine differentiation (3 lesions)

  • Adenocarcinoma (13 lesions

  • Thyroid cancer (18 lesions)

  • Differentiated (12 lesions)

  • Medullary (6 lesions)

  • Pheochromocytoma (4 lesions)

  • Adenoid cycstic carcinoma (4 lesions)

  • Gastric cancer (3 lesions)

  • Liver cancer (5 lesions)

  • Hepatocellular carcinoma (5 lesions)

  • Cervical cancer (3 lesions)

  • Small intestine cancer (6 lesions)

  • Neuroendocrine tumors (3 lesions

  • Anal cancer (3 lesions)

  • Colorectal cancer (38 lesions)

  • Chordoma (1 lesion)

  • Desmoid (4 lesions)

  • Ovarian cancer (8 lesions)

  • Head and neck cancer (34 lesions)

  • Thymus cancer (4 lesions)

  • Pancreatic cancer (51 lesions)

  • Lung cancer (25 lesions)

  • Breast cancer (12 lesions)

  • Cholangiocellular carcinoma (12 lesions)

  • Esophageal cancer (6 lesions)

  • Salivary gland cancer (6 lesions)

  • Sarcoma (8 lesions)

  • Cancer of unknown primary (7 lesions)

  • 68Ga- FAPI-04 (80 patients)

  • The highest uptake was observed in lung cancer, breast cancer, esophageal cancer as well as cholangiocellular carcinoma and sarcoma

  • The tracer showed low peritoneal uptake which facilitated diagnosis of peritoneal carcinomatosis

  • FAP-specific PET had limitations similar to those of FDG-PET for renal cell carcinoma, pheochromocytoma and thyroid cancer.

 Patent application none
68Ga-FAPI PET/CT: Biodistribution and Preliminary Dosimetry Estimate of 2 DOTA-Containing FAP-Targeting Agents in Patients with Various Cancers Giesel et al. [37] 2018

  • Breast cancer (2 patients)

  • Colorectal cancer (4 patients)

  • Cancer of unknown primary (2 patients)

  • Head and neck cancer (8 patients)

  • Liver cancer (2 patients)

  • Hepatocellular carcinoma (2 patients)

  • Sarcoma (1 patient)

  • Liposarcoma (1 patient)

  • Non small cell lung cancer (5 patients)

  • Esophageal cancer (2 patients)

  • Pancreatic cancer (13 patients)

  • Prostate cancer (4 patients)

  • Renal cancer (1 patient)

  • Thyroid cancer (3 patients)

  • Uterus cancer (1 patient)

  • Ovarian cancer (1 patient)

  • 68Ga-FAPI-02 (25 patients)

  • 68Ga- FAPI-04 (24 patients)

  • Tumor-to-background ratios of FAP-specific PET were at least similar to FDG-PET

 Patent application none