Paul Windisch1, Daniel R Zwahlen2, Frederik L Giesel3, Eberhard Scholz4,5,6, Patrick Lugenbiel4,5, Jürgen Debus7,8,9,10,11,12, Uwe Haberkorn3,13,14, Sebastian Adeberg7,8,9,10,11,12. 1. Department of Radiation Oncology, Kantonsspital Winterthur, Brauerstrasse 15, 8400, Winterthur, Switzerland. paul.windisch@ksw.ch. 2. Department of Radiation Oncology, Kantonsspital Winterthur, Brauerstrasse 15, 8400, Winterthur, Switzerland. 3. Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany. 4. Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany. 5. Heidelberg Center for Heart Rhythm Disorders (HCR), Heidelberg University Hospital, Heidelberg, Germany. 6. DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, University of Heidelberg, Heidelberg, Germany. 7. Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany. 8. Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany. 9. National Center for Tumor Diseases (NCT), Heidelberg, Germany. 10. Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany. 11. Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany. 12. German Cancer Consortium (DKTK), Partner Site, Heidelberg, Germany. 13. Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany. 14. Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.
Abstract
PURPOSE: Small molecules targeting fibroblast activation protein (FAP) have emerged as a new group of tracers for positron emission tomography (PET) in 2018. While most of the existing literature has been focussed on the application of FAP-specific PET in various kinds of cancers, some researchers have, both intentionally or unintentionally, used FAP-specific PET in patients with non-cancerous diseases. The purpose of this systematic review is therefore to summarize the available evidence of FAP-specific PET for non-malignant indications. METHODS: The MEDLINE database was searched for studies presenting the clinical use of FAP-specific PET, the records were screened according to PRISMA guidelines and articles containing patients suffering from non-malignant diseases were included. RESULTS: Sixteen studies with 303 patients were included. FAP-specific PET has been used in cardiac imaging, IgG4-related disease, benign tumors as well as various kinds of inflammation. Two prospective studies on FAP-specific PET for IgG4-related disease show its potential to differentiate inflammatory from fibrotic lesions, which could be used to determine the management of these patients. CONCLUSION: While publications on FAP-specific PET for non-malignant indications are mostly limited to case reports and incidental findings, the first retrospective and prospective studies present promising results for IgG4-related as well as cardiovascular disease that warrant further research. Several currently recruiting trials will add to the body evidence in the next few years.
PURPOSE: Small molecules targeting fibroblast activation protein (FAP) have emerged as a new group of tracers for positron emission tomography (PET) in 2018. While most of the existing literature has been focussed on the application of FAP-specific PET in various kinds of cancers, some researchers have, both intentionally or unintentionally, used FAP-specific PET in patients with non-cancerous diseases. The purpose of this systematic review is therefore to summarize the available evidence of FAP-specific PET for non-malignant indications. METHODS: The MEDLINE database was searched for studies presenting the clinical use of FAP-specific PET, the records were screened according to PRISMA guidelines and articles containing patients suffering from non-malignant diseases were included. RESULTS: Sixteen studies with 303 patients were included. FAP-specific PET has been used in cardiac imaging, IgG4-related disease, benign tumors as well as various kinds of inflammation. Two prospective studies on FAP-specific PET for IgG4-related disease show its potential to differentiate inflammatory from fibrotic lesions, which could be used to determine the management of these patients. CONCLUSION: While publications on FAP-specific PET for non-malignant indications are mostly limited to case reports and incidental findings, the first retrospective and prospective studies present promising results for IgG4-related as well as cardiovascular disease that warrant further research. Several currently recruiting trials will add to the body evidence in the next few years.
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