Fibroblast Activation Targeted Imaging Identifies Coronary Restenosis

A 49-year-old woman with chronic total occlusion of the proximal left anterior descending (LAD) artery underwent a baseline 18 F-FAPI PET/CT, and showed no abnormal uptake in the coronary artery. New focal 18 F-FAPI activity appeared at the LAD stent ostium at 6 months and progressed by 1 year, preceding angiographically confirmed in-stent restenosis. This case demonstrates that 18 F-FAPI imaging may detect early fibro-inflammatory activity predictive of restenosis.