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Fibroblast Activation Targeted Imaging Identifies Coronary Restenosis.

Xiao-Ying Xi1, Shengwen Yang2, Bin Tu2

  • 1Department of Nuclear Medicine.

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Summary

18F-FAPI PET/CT imaging may detect early inflammation in coronary artery stents. This fibro-inflammatory activity detected by 18F-FAPI imaging can predict in-stent restenosis, aiding in early diagnosis.

Keywords:
PET/CTcoronary atherosclerosisfibroblast activationin-stent restenosis

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Area of Science:

  • Cardiovascular Imaging
  • Nuclear Medicine
  • Interventional Cardiology

Background:

  • Coronary artery disease remains a leading cause of mortality worldwide.
  • In-stent restenosis (ISR) is a significant complication following percutaneous coronary intervention.
  • Current methods for detecting ISR often rely on invasive angiography, which carries risks and may not identify early pathological changes.

Purpose of the Study:

  • To investigate the potential of 18F-FAPI PET/CT imaging in detecting early fibro-inflammatory activity associated with coronary artery stent restenosis.
  • To evaluate if 18F-FAPI uptake can serve as a predictive biomarker for the development of ISR.

Main Methods:

  • A patient with chronic total occlusion of the left anterior descending (LAD) artery underwent baseline 18F-FAPI PET/CT.
  • Serial 18F-FAPI PET/CT scans were performed at 6 months and 1 year post-stenting.
  • Coronary angiography was used to confirm the presence and severity of in-stent restenosis.

Main Results:

  • Baseline 18F-FAPI PET/CT showed no abnormal uptake in the coronary artery prior to stenting.
  • Focal 18F-FAPI activity was observed at the LAD stent ostium at 6 months, which progressed by 1 year.
  • The appearance and progression of 18F-FAPI uptake preceded the angiographically confirmed diagnosis of in-stent restenosis.

Conclusions:

  • 18F-FAPI PET/CT imaging may identify early fibro-inflammatory processes within coronary artery stents.
  • This novel imaging approach shows promise in predicting the development of in-stent restenosis.
  • 18F-FAPI imaging could offer a non-invasive method for early detection and risk stratification of ISR.