Molecular imaging of arterial fibroblast activation protein: association with calcified plaque burden and cardiovascular risk factors

Autor: Aleksander Kosmala, Sebastian E. Serfling, Kerstin Michalski, Thomas Lindner, Andreas Schirbel, Takahiro Higuchi, Philipp E. Hartrampf, Thorsten Derlin, Andreas K. Buck, Alexander Weich, Rudolf A. Werner
Rok vydání: 2023
Předmět:
Zdroj: European Journal of Nuclear Medicine and Molecular Imaging.
ISSN: 1619-7089
1619-7070
Popis: Purpose We aimed to assess prevalence, distribution, and intensity of in-vivo arterial wall fibroblast activation protein (FAP) uptake, and its association with calcified plaque burden, cardiovascular risk factors (CVRFs), and FAP-avid tumor burden. Methods We analyzed 69 oncologic patients who underwent [68 Ga]Ga-FAPI-04 PET/CT. Arterial wall FAP inhibitor (FAPI) uptake in major vessel segments was evaluated. We then investigated the associations of arterial wall uptake with calcified plaque burden (including number of plaques, plaque thickness, and calcification circumference), CVRFs, FAP-positive total tumor burden, and image noise (coefficient of variation, from normal liver parenchyma). Results High focal arterial FAPI uptake (FAPI +) was recorded in 64/69 (92.8%) scans in 800 sites, of which 377 (47.1%) exhibited concordant vessel wall calcification. The number of FAPI + sites per patient and (FAPI +)-derived target-to-background ratio (TBR) correlated significantly with the number of calcified plaques (FAPI + number: r = 0.45, P r = − 0.26, P = 0.04), calcified plaque thickness (FAPI + number: r = 0.33, P r = − 0.29, P = 0.02), and calcification circumference (FAPI + number: r = 0.34, P r = − 0.26, P = 0.04). In univariate analysis, only body mass index was significantly associated with the number of FAPI + sites (OR 1.06; 95% CI, 1.02 − 1.12, P r = 0.30) and the number of FAPI + sites (r = 0.28; P = 0.02, respectively). In addition, there was no significant interaction between FAP-positive tumor burden and arterial wall FAPI uptake (P ≥ 0.13). Conclusion [68 Ga]Ga-FAPI-04 PET identifies arterial wall lesions and is linked to marked calcification and overall calcified plaque burden, but is not consistently associated with cardiovascular risk. Apparent wall uptake may be partially explained by image noise.
Databáze: OpenAIRE
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