[68Ga]Ga-DOTA-FAPI-04 PET/MR in patients with acute myocardial infarction: potential role of predicting left ventricular remodeling

Eur J Nucl Med Mol Imaging. 2023 Feb;50(3):839-848. doi: 10.1007/s00259-022-06015-0. Epub 2022 Nov 3.

Abstract

Purpose: To assess predictive value of 68Ga-labeled fibroblast activation protein inhibitor-04 ([68Ga]Ga-DOTA-FAPI-04) PET/MR for late left ventricular (LV) remodeling in patients with ST-segment elevated myocardial infarction (STEMI).

Methods: Twenty-six patients with STEMI were included in the study. [68Ga]Ga-DOTA-FAPI-04 PET/MR was performed at baseline and at average 12 months after STEMI. LV remodeling was defined as >10% increase in LV end-systolic volume (LVESV) from baseline to 12 months.

Results: The LV remodeling group demonstrated higher [68Ga]Ga-DOTA-FAPI-04 uptake volume (UV) at baseline than the non-LV remodeling group (p < 0.001). [68Ga]Ga-DOTA-FAPI-04 UV at baseline was a significant predictor (OR = 1.048, p = 0.011) for LV remodeling at 12 months after STEMI. Compared to clinical information, MR imaging and cardiac function parameters at baseline, [68Ga]Ga-DOTA-FAPI-04 UV demonstrated better predictive ability (AUC = 0.938, p < 0.001) for late LV remodeling, with sensitivity of 100.0% and specificity of 81.3%.

Conclusions: [68Ga]Ga-DOTA-FAPI-04 PET/MR is an effective tool to non-invasively quantify myocardial fibroblasts activation, and baseline [68Ga]Ga-DOTA-FAPI-04 UV may have potential predictive value for late LV remodeling.

Keywords: Acute myocardial infarction; Fibroblast activation protein inhibitor; Left ventricular remodeling; Myocardial fibrosis; PET/MR.

MeSH terms

  • Gallium Radioisotopes
  • Humans
  • Magnetic Resonance Imaging
  • Myocardial Infarction* / diagnostic imaging
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography
  • ST Elevation Myocardial Infarction*
  • Ventricular Function, Left
  • Ventricular Remodeling

Substances

  • 68Ga-FAPI
  • Gallium Radioisotopes
  • 1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid