TY  - JOUR
AU  - Deleu, Anne-Leen
AU  - Shagera, Qaid Ahmed
AU  - Veldhuijzen van Zanten, Sophie
AU  - Flamen, Patrick
AU  - Gheysens, Olivier
AU  - Hautzel, Hubertus
TI  - FAPI PET in the Management of Lung Tumors.
JO  - Seminars in nuclear medicine
VL  - 55
IS  - 2
SN  - 0001-2998
CY  - New York, NY [u.a.]
PB  - Elsevier
M1  - DKFZ-2025-00482
SP  - 202-211
PY  - 2025
N1  - 2025 Mar;55(2):202-211
AB  - Fibroblast activation protein (FAP), selectively expressed on activated fibroblasts in proliferating tissues, is emerging as a promising target in oncology. In lung cancer, the leading cause of cancer-related deaths worldwide, [18F]FDG PET/CT has set the bar high and earned widespread recognition in clinical guidelines for its essential role in staging and follow-up. Yet, FAP-targeted imaging agents like FAPI PET/CT have demonstrated significant potential due to their high tumor specificity, rapid tracer uptake, and low background activity. This review focuses on the role of FAPI PET/CT in lung cancer, highlighting its applications in staging, biomarker evaluation, and clinical management. FAP expression correlates with cancer associated fibroblast-driven tumorigenesis in lung cancer, showing higher expression in nonsmall cell lung cancer (NSCLC) than in small cell lung cancer (SCLC) subtypes. Studies reveal that FAPI PET/CT provides comparable or superior detection rates for primary tumors and metastases compared to [18F]FDG PET/CT, particularly in brain, pleural, and bone lesions. It also enhances accuracy in lymph node staging, influencing disease management by enabling surgical resection in cases misclassified by [18F]FDG PET/CT. Despite these advantages, several challenges remain, such as differentiating benign from malignant lesions, assessing FAPI's prognostic implications or its role in treatment response monitoring. Future directions include exploring FAPI-based theranostics, standardizing radiopharmaceuticals, and conducting well-designed, adequately powered prospective trials. FAPI PET/CT represents a transformative diagnostic tool, complementing or potentially surpassing [18F]FDG PET/CT in precision lung cancer care.
LB  - PUB:(DE-HGF)16
C6  - pmid:40037979
DO  - DOI:10.1053/j.semnuclmed.2025.02.011
UR  - https://inrepo02.dkfz.de/record/299524
ER  -