The Role of Fibroblast Activation Protein Inhibitor Positron Emission Tomography in Inflammatory and Infectious Diseases: An Updated Systematic Review

Author:

Albano Domenico12ORCID,Rizzo Alessio3ORCID,Slart Riemer H. J. A.45ORCID,Hess Søren67ORCID,Noriega-Álvarez Edel8ORCID,Wakfie-Corieh Cristina Gamila910ORCID,Leccisotti Lucia1112ORCID,Glaudemans Andor W. J. M.4ORCID,Gheysens Olivier13,Treglia Giorgio141516ORCID

Affiliation:

1. Nuclear Medicine, ASST Spedali Civili Brescia, 25128 Brescia, Italy

2. Nuclear Medicine Department, University of Brescia, 25121 Brescia, Italy

3. Nuclear Medicine Division, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy

4. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

5. Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, 7522 NB Enschede, The Netherlands

6. Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark

7. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, Denmark

8. Department of Nuclear Medicine, University Hospital of Guadalajara, 19002 Guadalajara, Spain

9. Department of Nuclear Medicine, Hospital Clínico San Carlos, 28040 Madrid, Spain

10. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain

11. Section of Nuclear Medicine, Department of Radiological Sciences and Haematology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy

12. Unit of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy

13. Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium

14. Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland

15. Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland

16. Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland

Abstract

The role of fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) is emerging for the assessment of non-oncological diseases, such as inflammatory and infectious diseases, even if the evidence in the literature is still in its initial phases. We conducted a systematic search of Scopus, PubMed/MEDLINE, Embase, and Cochrane library databases for studies published before 31 December 2023 reporting infectious and inflammatory disease imaging with FAPI PET/CT. We included twenty-one studies for a total of 1046 patients. The most frequent disease studied was lung interstitial disease, investigated in six studies for a total of 200 patients, followed by bone and joint diseases in two studies and 185 patients, IgG4-related disease in 53 patients, and Crohn’s disease in 30 patients. Despite the heterogeneity of studies in terms of study design and technical features, FAPI PET/CT showed a high detection rate and diagnostic role. Moreover, when compared with 2-[18F]FDG PET/CT (n = 7 studies), FAPI PET/CT seems to have better diagnostic performances. The presence of chronic inflammation and tissue remodeling, typical of immune-mediated inflammatory conditions, may be the underlying mechanism of FAPI uptake.

Publisher

MDPI AG

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