To evaluate the effect of an anti-fibrotic treatment initiation on the fibrotic activity as assessed by FAPI PET/CT.
To evaluate the use of the fibroblast activation protein (FAP) as a biomarker of fibrotic lung disease (idiopathic pulmonary fibrosis (IPF) and non-IPF ILDs). The study will include both analysis of FAP expression in samples stored in the biobank of the department of Pneumology (BAL, blood, induced sputum and EBC) (cohort A) and lung FAPI uptake on PET/CT scans performed at the department of Nuclear Medicine: * before and after the initiation of an antifibrotic therapy (IPF or PPF) (cohort B) * before and after the initiation of corticosteroid therapy in case of an acute exacerbation of ILD (cohort C) * before and after the initiation of an immunosuppressive drug in the context of non-IPF pulmonary fibrosis (cohort D). * before lung transplantation, surgery or biopsy to correlate with FAP expression determined by immunohistochemical analysis (IHC) (cohort E).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
70
In the department of Nuclear Medicine: * Installation in a relax chair after weight and height control * Placement of a venous line in the upper limb after which an infusion of 500ml of 0.9% NaCl is started. * Intravenous injection of 3 MBq/kg (max 300 MBq) of 18F- FAPI 74 or of 2 MBq/kg 68Ga-FAPI46
Medecine
Brussels, Belgium
RECRUITINGFAPI uptake on PET/CT
Decrease in lung FAPI uptake after the initiation of treatment, measured with the following PET parameters: SUVmax, SUVmean and Total lesion fapi uptake (TLA) in the lungs of the patients
Time frame: From date of inclusion till date of the second FAPI PET/CT (after 3 months)
Correlation between lung FAP expression and clinical evolution
Correlation between lung FAP expression (as assessed on blood/BAL or on FAPI PET/CT) and the clinical evolution based on the analysis of the slope of FVC decreased, absolute and relative changes in FVC at 12 months, time to progression/death or lung transplantation, time to first acute exacerbation
Time frame: From date of inclusion for a period of 2 years
Comparison of different FAPi tracers
Comparison of PET parameters on 68Ga-FAPI and 18F-FAPI images (SUVmax, SUVmean) in lungs
Time frame: From date of inclusion till the second FAPi PET/CT (maximum period of 4 weeks)
Comparison of different FAPi tracers
Comparison of PET parameters of 68Ga-FAPI and 18F-FAPI images (SUVmax, SUVmean) in blood pool
Time frame: From date of inclusion till the second FAPi PET/CT (maximum period of 4 weeks)
Correlation between lung FAPI uptake and corresponding FAP assessment in blood and BAL samples.
Correlation between lung FAPI uptake on the PET images (SUVmean, SUVmax, TLA) and corresponding quantitative FAP assessment in blood and BAL samples.
Time frame: From date of inclusion till last BAL sample taken, up to a maximum period of 2 years follow-up
Correlation between lung FAPI uptake and immunohistological evaluation of the FAP expression on lung samples (after lung transplantation, surgical lung biopsy or cryobiopsy)
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Correlation between lung FAPI uptake on the PET images (SUVmean, SUVmax, TLA) and immunohistological evaluation of the FAP expression on lung samples (after lung transplantation, surgical lung biopsy or cryobiopsy)
Time frame: From date of inclusion until surgery, for a maximum period of 2 years