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. 2024 May;51(6):1605-1611.
doi: 10.1007/s00259-023-06564-y. Epub 2023 Dec 20.

Initial results with [18F]FAPI-74 PET/CT in idiopathic pulmonary fibrosis

Yuriko Mori  1 , Vasko Kramer  2   3 , Emil Novruzov  4 , Eduards Mamlins  4 , Manuel Röhrich  5   6 , René Fernández  2 , Horacio Amaral  2   3 , Cristian Soza-Ried  2   3 , Barbara Monje  2 , Eduardo Sabbagh  7 , Matías Florenzano  7   8 , Frederik L Giesel #  4   9 , Álvaro Undurraga #  7   10
Affiliations

Initial results with [18F]FAPI-74 PET/CT in idiopathic pulmonary fibrosis

Yuriko Mori et al. Eur J Nucl Med Mol Imaging. 2024 May.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial lung disease with a poor prognosis. 68Ga-labeled FAP ligands exhibited highly promising results due to the crucial role of activated fibroblasts in fibrosis imaging of the lung. However, 18F-labeled FAP ligands might provide qualitatively much higher imaging results with accompanying economic benefits due to large-scale production. Thus, we sought to investigate the potential of [18F]FAPI-74 prospectively in a small patient cohort.

Methods: Eight patients underwent both [18F]FAPI-74-PET/CT and HRCT scans and were then compared with a control group without any fibrosing pulmonary disease. The tracer uptake of fibrotic lung areas was analyzed in synopsis with radiological and clinical parameters.

Results: We observed a positive correlation between the fibrotic active volume, the Hounsfield scale, as well as the vital and diffusing capacity of the lung.

Conclusion: The initial results confirm our assumption that [18F]FAPI-74 offers a viable non-invasive assessment method for pulmonary fibrotic changes in patients with IPF.

Keywords: FAPI; Fibroblast activation protein; Fibrosis; Idiopathic pulmonary disease; PET.

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Conflict of interest statement

FLG has a patent application for quinolone-based FAP-targeting agents for imaging and therapy in nuclear medicine and shares a consultancy group for iTheranostics. FLG is also an advisor at ABX, Telix, Alpha Fusion, and SOFIE Biosciences. The other authors declare no conflict of interest regarding this manuscript.

Figures

Fig.1
Fig.1
Positive [18F]FAPI-74 uptake in fibrotic lung tissue. Representative image of [18F]FAPI-74-PET/CT scan in a 68-year-old male patient with idiopathic pulmonary fibrosis in axial fusion (A), PET (B), CT (C) and maximum intensity projection (D). Positive tracer uptake is present in concordant regions in radiographic findings, but not in the non-fibrotic areas. Corresponding images of a 56-year-old male patient with pancreatic adenocarcinoma without any known lung disorder as control (E–H)
Fig. 2
Fig. 2
[18F]FAPI-74 uptake in FAV of fibrotic lung. Representative image of [18F]FAPI-74-PET/CT scan in a 76-year-old male patient with idiopathic pulmonary fibrosis with marked region of fibrotic active volume (FAV) (A), maximum intensity projection (B), PET (C), CT and (D) fusion
Fig. 3
Fig. 3
[18F]FAPI-74 uptake in patients with IPF. SUV data obtained in the patients and in controls are displayed as Whisker plots. a SUVmax of [18F]FAPI-74 uptake of IPF patients vs controls. b SUVmean of [18F]FAPI-74 uptake of IPF patients vs. controls
Fig. 4
Fig. 4
Correlation between [18F]FAPI-74 uptake and radiological and clinical parameters. a Correlation between SUVmean and Hounsfield scale in CT. b Correlation between fibrotic active volume (FAV) and pulmonary function (FVC, forced vital capacity). c Correlation between fibrotic active volume (FAV) and CO diffusing capacity (DLCO)
See this image and copyright information in PMC

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