# FAPI PET

Source: https://nuclide.cc/technologies/fapi-pet/  
Nuclide record `fapi-pet` (Technology). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

FAPI PET is a PET scan that lights up the scaffolding around almost any solid tumour, including cancers the standard sugar scan misses.

## Summary

Quinoline-based FAP inhibitors (FAPI-04, FAPI-46, FAPI-74) labelled with 68Ga or 18F image cancer-associated fibroblasts. Superior to FDG in pancreatic, gastric, HCC, and peritoneal disease in head-to-head series. Registrational trials for 68Ga-FAPI-46 and 18F-FAPI-74 (Sofie) are underway. Pairs with FAP-targeted radioligands.

## Fields

- Kind: Technology
- Status: phase-3
- Last checked: 2026-09-04
- Principle: Small molecule binds FAP on stromal fibroblasts; rapid uptake, low background, minimal brain and liver signal.
- Since: 2018
- Strengths: Pan-cancer, high contrast; No fasting needed; Sees desmoplastic tumours FDG misses
- Limitations: Also uptake in fibrosis, healing, arthritis; Reports stroma not tumour cells; Not yet approved

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Fibroblast_activation_protein,_alpha
- Wikipedia: https://en.wikipedia.org/wiki/Fibroblast_activation_protein,_alpha

## Connected records

- isotopes: [Fluorine-18](https://nuclide.cc/isotopes/f-18/), [Gallium-68](https://nuclide.cc/isotopes/ga-68/)
- indications: [Hepatocellular carcinoma](https://nuclide.cc/indications/hcc/), [Non-small cell lung cancer](https://nuclide.cc/indications/nsclc/), [Pancreatic ductal adenocarcinoma](https://nuclide.cc/indications/pancreatic-cancer/)
- technologies: [FES PET (oestrogen receptor imaging)](https://nuclide.cc/technologies/fes-pet/), [PET (positron emission tomography)](https://nuclide.cc/technologies/pet/)
- targets: [FAP](https://nuclide.cc/targets/fap/)
- drugs: [FAP-2286 (177Lu / 68Ga)](https://nuclide.cc/drugs/fap-2286/), [Gallium-68 FAPI-46](https://nuclide.cc/drugs/ga-68-fapi-46/), [Lead-212 PSV359](https://nuclide.cc/drugs/pb-212-psv359/)
- companies: [SOFIE Biosciences](https://nuclide.cc/companies/sofie-biosciences/)
- institutions: [All India Institute of Medical Sciences, New Delhi](https://nuclide.cc/institutions/aiims-delhi/), [Curanosticum Wiesbaden-Frankfurt](https://nuclide.cc/institutions/curanosticum/), [European Association of Nuclear Medicine](https://nuclide.cc/institutions/eanm/), [Heidelberg University Hospital / NCT / DKFZ](https://nuclide.cc/institutions/heidelberg-nct/), [TUM Klinikum rechts der Isar / CCC München](https://nuclide.cc/institutions/tum-munich/), [University Hospital Düsseldorf / CIO Düsseldorf](https://nuclide.cc/institutions/uk-duesseldorf/)
- roadmaps: [Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET](https://nuclide.cc/roadmaps/molecular-imaging-roadmap/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://nuclide.cc/roadmaps/radiopharma-roadmap/)
- ideas: [A university cyclotron network with shared regulatory files for new tracers](https://nuclide.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [FAP theranostics as a pan-cancer stromal strategy](https://nuclide.cc/ideas/idea-fap-theranostics-pancancer/), [FAP-targeted radioligand therapy for sarcoma](https://nuclide.cc/ideas/idea-fap-theranostics-sarcoma/), [FAPI PET as the workup for MCED positives](https://nuclide.cc/ideas/idea-mced-plus-fapi/)
- people: [Andrei Iagaru](https://nuclide.cc/people/andrei-iagaru/), [Frederik Giesel](https://nuclide.cc/people/frederik-giesel/), [Ken Herrmann](https://nuclide.cc/people/ken-herrmann/), [Shaoli Song](https://nuclide.cc/people/song-shaoli/), [Uwe Haberkorn](https://nuclide.cc/people/uwe-haberkorn/), [Wolfgang A. Weber](https://nuclide.cc/people/wolfgang-weber/)
- opportunities: [FAP imaging to stop futile pancreatic surgery](https://nuclide.cc/opportunities/opp-fap-pancreatic-staging/)
- fronts: [Molecular imaging](https://nuclide.cc/fronts/f-molecular-imaging/)

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