Summary: SNMMI and the European Association of Nuclear Medicine have released new guidelines for fibroblast activation protein PET imaging, detailing its cancer and disease applications, offering evidence-based recommendations, and emphasizing the need for further clinical trials.

Key Takeaways

  • New FAP PET Guidelines Released: SNMMI and the European Association of Nuclear Medicine have issued evidence-based guidelines to assist providers in recommending, performing, interpreting, and reporting fibroblast activation protein PET imaging studies.
  • Applications in Cancer and Beyond: FAP PET imaging is highlighted for staging, re-staging, therapy evaluation, and whole-body target assessment in cancers such as gastrointestinal, pancreatic, and breast, with additional potential in non-oncologic uses like inflammation and fibrosis.
  • Call for Further Research: The authors emphasize the need for clinical trials to establish FAP PET’s clinical utility, secure regulatory approval, and assess its impact on disease detection and treatment evaluation.

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The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have released a new guideline for fibroblast activation protein (FAP) PET imaging. Published in The Journal of Nuclear Medicine (January issue), the guideline aims to assist providers in recommending, performing, interpreting, and reporting FAP PET studies.

FAP, a transmembrane protein found on cancer-associated fibroblasts and activated fibroblasts involved in tissue repair, has long been a cancer therapy target. The development of FAP-targeted radioligands has sparked growing interest in its use for imaging cancer and other diseases.

“FAP PET imaging is valuable for initial staging, re-staging, therapy response evaluation, and assessing whole-body target expression for therapy selection,” the authors write. The guideline provides evidence-based recommendations to help physicians deliver optimal diagnostic accuracy and study quality.

FAP PET’s Utility and Regulatory Approval

The guideline highlights FAP PET’s oncologic applications, including imaging for gastrointestinal, pancreatic, esophageal, head and neck, thyroid, lung, ovarian, and breast cancers. Non-oncologic uses, such as assessing inflammation and fibrosis, are also outlined. It details imaging personnel qualifications, responsibilities, and standardized procedures for quality control and imaging.

“FAP PET is in its early stages, and our understanding of its role will evolve,” the authors note. They emphasized the need for well-designed clinical trials to clarify its clinical utility and gain regulatory approval. Understanding the impact of improved disease detection and treatment assessment will also be critical. “FAP PET shows great promise, and we are excited about its future in clinical practice.”

The full guideline is available on the SNMMI website.