Imaging of cardiac fibroblast activation in a patient after acute myocardial infarction using 68Ga-FAPI-04

Susan Notohamiprodjo, Stephan G. Nekolla, Stephanie Robu, Alberto Villagran Asiares, Christian Kupatt, Tareq Ibrahim, Karl Ludwig Laugwitz, Marcus R. Makowski, Markus Schwaiger, Wolfgang A. Weber, Zohreh Varasteh

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56 Scopus citations

Abstract

Our previous study has demonstrated the feasibility of noninvasive imaging of fibroblast activation protein (FAP)-expression after myocardial infarction (MI) in MI-territory in a rat model with 68Ga-FAPI-04-PET. In the current extended clinical case, we sought to delineate cardiac uptake of 68Ga-FAPI-04 in a patient after MI with clinical indication for the evidence of fibroblast activation. Carcinoma patients without cardiac disease underwent 68Ga-FAPI-04-PET/CT as control. The patient with one-vessel disease underwent dynamic 68Ga-FAPI-04-cardiac-PET/CMR for 60 minutes. Correlation of cardiac 68Ga-FAPI-04 uptake with clinical findings, ECG, echocardiography, coronary-arteriography and enhanced cardiac-MRI with T1 MOLLI and ECV mapping were performed. No uptake was found in normal myocardium and in mature scar. A focal intense 68Ga-FAPI-04 uptake with continuous wash-out in the infarct territory of coronary occlusion correlating with T1 and ECV mapping was observed. The uptake of 68Ga-FAPI-04 extends beyond the actual infarcted area and overestimates the infarct size as confirmed by follow-up CMR.

Original languageEnglish
Pages (from-to)2254-2261
Number of pages8
JournalJournal of Nuclear Cardiology
Volume29
Issue number5
DOIs
StatePublished - Oct 2022

Keywords

  • CAD
  • PET
  • diagnostic and prognostic application
  • hybrid imaging
  • molecular imaging agents
  • myocardial ischemia and infarction

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