Increased 68Ga-FAPI Uptake in Active Atherosclerotic Plaque

Abstract

A 67-year-old man with esophageal cancer was included in a clinical trial of a 68 Ga-FAPI PET/CT study on tumors (ChiCTR2100044131). Increased tracer uptake was noted in the esophageal cancer with esophagitis. In addition, active coronary atherosclerotic plaque also revealed increased FAPI activity.

Diagnostic and Therapeutic Application of Fibroblast Activation Protein Inhibitors in Oncologic and Nononcologic Diseases

“…102,103 FAPI uptake in unstable atherosclerotic plaques (SUV max : 2.2-3.7) has been reported in few case reports. 104,105 Of note, vulnerable plaque but not stable plaques showed focal FAPI uptake. 104 Additionally, studies have suggested that diffuse FAPI uptake in arterial walls may indicate the presence of large-vessel vasculitis such as Takayasu arteritis and giant cell arteritis.…”

“…Studies suggest a connection between FAP expression and plaque vulnerability in atherosclerosis 102,103 . FAPI uptake in unstable atherosclerotic plaques (SUV max : 2.2–3.7) has been reported in few case reports 104,105 . Of note, vulnerable plaque but not stable plaques showed focal FAPI uptake 104 .…”

Highlighting Fibroblasts Activation in Fibrosis: The State-of-The-Art Fibroblast Activation Protein Inhibitor PET Imaging in Cardiovascular Diseases

“…In addition, [ 68 Ga]Ga-FAPI uptake in the right ventricle (RV) was observed in pressure overload cardiac diseases, such as idiopathic pulmonary arterial hypertension (IPAH) and hypertensive heart disease [54,56]. Likewise, investigation of FAPI PET in vascular diseases, such as thrombosis and atherosclerosis, was initiated because of accidental FAPI uptake in patients with various diseases [70,[72][73][74].…”