Department of Cardiology and Vascular Medicine, University of Essen Medical School, West German Heart and Vascular Center Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), Partner Site Munich Heart Alliance, Munich, Germany.
J Nucl Cardiol. 2021 Jun;28(3):812-821. doi: 10.1007/s12350-020-02307-w. Epub 2020 Sep 25.
Fibroblast activation protein (FAP) as a specific marker of activated fibroblasts can be visualized by positron emission tomography (PET) using Ga-68-FAP inhibitors (FAPI). Gallium-68-labeled FAPI is increasingly used in the staging of various cancers. In addition, the first cases of theranostic approaches have been reported. In this work, we describe the phenomenon of myocardial FAPI uptake in patients who received a Ga-68 FAPI PET for tumor staging.
Ga-68 FAPI PET examinations for cancer staging were retrospectively analyzed with respect to cardiac tracer uptake. Standardized uptake values (SUV) were correlated to clinical covariates in a univariate regression model. From 09/2018 to 11/2019 N = 32 patients underwent FAPI PET at our institution. Six out of 32 patients (18.8%) demonstrated increased localized myocardial tracer accumulation, with remote FAPI uptake being significantly higher in patients with vs without localized focal myocardial uptake (SUV 2.2 ± .6 vs 1.5 ± .4, P < .05 and SUV 1.6 ± .4 vs 1.2 ± .3, P < .05, respectively). Univariate regression demonstrated a significant correlation of coronary artery disease (CAD), age and left ventricular ejection fraction (LVEF) with remote SUV uptake, the latter with a very strong correlation with remote uptake (R = .74, P < .01).
Our study indicates an association of CAD, age, and LVEF with FAPI uptake. Further studies are warranted to assess if fibroblast activation can be reliably measured and may be used for risk stratification regarding early detection or progression of CAD and left ventricular remodeling.
成纤维细胞活化蛋白（FAP）作为活化成纤维细胞的特异性标志物，可通过正电子发射断层扫描（PET）使用 Ga-68-FAP 抑制剂（FAPI）进行可视化。镓-68 标记的 FAPI 越来越多地用于各种癌症的分期。此外，已经报道了首例治疗诊断方法的病例。在这项工作中，我们描述了在接受 Ga-68 FAPI PET 进行肿瘤分期的患者中出现心肌 FAPI 摄取的现象。
回顾性分析了用于癌症分期的 Ga-68 FAPI PET 检查中的心导管摄取情况。在单变量回归模型中，将标准化摄取值（SUV）与临床协变量相关联。2018 年 9 月至 2019 年 11 月，N = 32 例患者在我院接受 FAPI PET 检查。32 例患者中有 6 例（18.8%）出现局部心肌示踪剂摄取增加，有局部局灶性心肌摄取的患者与无局部局灶性心肌摄取的患者相比，远程 FAPI 摄取明显更高（SUV 2.2 ±.6 与 1.5 ±.4，P <.05 和 SUV 1.6 ±.4 与 1.2 ±.3，P <.05）。单变量回归表明，冠心病（CAD）、年龄和左心室射血分数（LVEF）与远程 SUV 摄取呈显著相关，后者与远程摄取呈很强的相关性（R =.74，P <.01）。
我们的研究表明，CAD、年龄和 LVEF 与 FAPI 摄取有关。需要进一步研究以评估是否可以可靠地测量成纤维细胞活化，并可用于 CAD 早期检测或进展和左心室重构的风险分层。
