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Published on: December 19, 2013
Potential of 68Ga-FAPI-04 PET/MR to predict worsening renal function after acute ST-elevation myocardial infarction
Lei Yi1, Weiwei Quan1, Min Zhang2
1Department of cardiovascular medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose:
The fibroblast activation protein inhibitor-04 (FAPI-04) specifically binds to the FAP of activated myocardial fibroblasts, which makes 68Ga-labelled FAPI-04 (68Ga-FAPI-04) positron emission tomography (PET)/magnetic resonance (MR) a new potential imaging technique for the evaluation of myocardial fibrosis. This study aimed to evaluate the potential value of 68Ga-FAPI-04 PET/MR in assessing and predicting changes in renal function in patients with acute ST-elevation myocardial infarction (STEMI).
Methods:
Thirty-three patients with STEMI were included in this study. 68Ga-FAPI-04 PET/MR and cardiac magnetic resonance were performed before discharge in all patients. Worsening renal function(WRF) was defined as ≥20% decrease in estimated glomerular filtration rate(eGFR) from baseline to 12 months.
Results:
The WRF group demonstrated higher 68Ga-FAPI-04 uptake volume (UV) at baseline than the non-WRF group(P = 0.009). 68Ga-FAPI-04 UV at baseline was correlated with follow-up eGFR (r = -0.493, P = 0.004). 68Ga-FAPI-04 UV at baseline was a significant predictor of WRF (OR = 1.014, P = 0.029) at 12 months after STEMI.
Conclusions:
As an effective tool to non-invasively quantify myocardial fibroblast activation, 68Ga-FAPI-04 PET/MR has potential value for assessing and predicting worsening renal function in patients with STEMI.
Insights
Positron emission tomography (PET)/magnetic resonance (MR) using 68Ga-FAPI-04 can assess myocardial fibroblast activation. This imaging technique shows potential for predicting worsening renal function in ST-elevation myocardial infarction (STEMI) patients.
Area of Science:
- Cardiovascular Imaging
- Radiopharmaceuticals
- Renal Function Assessment
Background:
- Fibroblast Activation Protein (FAP) is expressed by activated myocardial fibroblasts.
- 68Ga-labelled FAPI-04 (68Ga-FAPI-04) positron emission tomography (PET)/magnetic resonance (MR) targets FAP, offering a novel approach for myocardial fibrosis evaluation.
- Acute ST-elevation myocardial infarction (STEMI) can impact renal function.
Purpose of the Study:
- To evaluate the utility of 68Ga-FAPI-04 PET/MR in assessing myocardial fibroblast activation.
- To determine if 68Ga-FAPI-04 PET/MR can predict changes in renal function post-STEMI.
Main Methods:
- Thirty-three STEMI patients underwent 68Ga-FAPI-04 PET/MR and cardiac MR before discharge.
- Worsening renal function (WRF) was defined as a ≥20% decrease in estimated glomerular filtration rate (eGFR) at 12 months.
- Baseline 68Ga-FAPI-04 uptake volume (UV) was analyzed.
Main Results:
- Patients who developed WRF had significantly higher baseline 68Ga-FAPI-04 UV compared to those without WRF (P=0.009).
- Baseline 68Ga-FAPI-04 UV correlated negatively with 12-month follow-up eGFR (r=-0.493, P=0.004).
- Baseline 68Ga-FAPI-04 UV was a significant predictor of WRF at 12 months (OR=1.014, P=0.029).
Conclusions:
- 68Ga-FAPI-04 PET/MR effectively quantifies myocardial fibroblast activation non-invasively.
- This imaging modality holds potential for assessing and predicting worsening renal function in STEMI patients.
- 68Ga-FAPI-04 PET/MR may serve as a valuable tool in managing STEMI complications.
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