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Gallium-68 FAPI (Fibroblast Activation Protein Inhibitor) is a class of radiopharmaceutical PET imaging tracers designed to target fibroblast activation protein (FAP), a cell-surface protease highly expressed by cancer-associated fibroblasts (CAFs) in the stroma of most epithelial cancers. Developed initially at Heidelberg University and further advanced by SOFIE Biosciences and GE Healthcare (specifically the FAPI-46 variant), these tracers utilize the positron-emitting isotope gallium-68 to visualize the tumor microenvironment. Beyond oncology, Ga-68 FAPI is being investigated for imaging non-malignant conditions characterized by tissue remodeling and fibrosis, such as inflammatory bowel disease (Crohn's disease and ulcerative colitis) and myocardial infarction. The tracers are noted for their high target-to-background ratio, rapid clearance, and ability to detect lesions that are often poorly visualized by standard FDG-PET, such as those in the liver, pancreas, and brain.
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