Journal of Capital Medical University ›› 2022, Vol. 43 ›› Issue (6): 845-853.doi: 10.3969/j.issn.1006-7795.2022.06.005

• Nuclear Medicine and Molecular Imaging Assists Clinical Diagnosis and Treatment • Previous Articles     Next Articles

Preliminary study of 18F-FAPI PET/CT in hypertrophic cardiomyopathy: comparison with cardiac magnetic resonance imaging

Zhang Yu1, Dong Zhixiang2, Li Changcheng3, Wang Li1, Yang Minfu1*   

  1. 1. Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
    2. Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;
    3. Department of Radiology,Taian City Central Hospital, Taian 271099, Shandong Province, China
  • Received:2022-09-30 Online:2022-12-21 Published:2022-11-30
  • Contact: *E-mail:minfuyang@126.com

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Abstract: Objective To explore the characteristics of 18F-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) in the patients with hypertrophic cardiomyopathy (HCM), as well as the correlation between 18F-FAPI activity and cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) technique. Methods Twenty-two HCM patients were prospectively recruited in this study with 18F-FAPI PET/CT examination, CMR examination and blood tests. A control group of twenty-two healthy participants with the same age and sex as the HCM group was also recruited and only underwent 18F-FAPI PET/CT examination. The maximum standardized uptake value (SUVmax) and maximum target-to-background ratio (TBRmax) of left ventricular (LV) myocardium were then obtained by post-processing software. The region grow algorithm with a threshold of 40% of the SUVmax was set to determine the 18F-FAPI volume. The 18F-FAPI volume was further expressed as a percentage of LV volume derived from CMR, which was defined as the 18F-FAPI extent (FAPI%). CMR examination was performed on a 3.0 Tesla scanner. The maximum thickness and LGE extent (LGE%) of LV myocardium were then obtained by post-processing software. The independent-sample t test or Mann Whitney U test was used to evaluate the differences of 18F-FAPI uptake between the patients with HCM and healthy participants. The correlation of 18F-FAPI activity and CMR parameters were assessed by Pearson/Spearman's correlation test. Results The myocardial 18F-FAPI uptake of LV in patients with HCM was significantly higher than that in the healthy participants (TBRmax, median: 8.96 vs 1.19, P<0.001). In patients with HCM, the 18F-FAPI extent was larger than LGE extent (FAPI% vs LGE%, median: 73.77 vs 6.69, P<0.001), and moderate correlation was observed between 18F-FAPI extent, LGE extent and LVEF (FAPI, LGE% and LVEF, r = 0.67,-0.49, P<0.05).Moreover, moderate correlation was observed between 18F-FAPI extent with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatine kinase-MB (CK-MB) (FAPI% , NT-proBNP and CK-MB, r = 0.58,0.54, P<0.05). No correlation was observed between CMR parameters and blood tests. Conclusion The measurement of 18F-FAPI was moderately correlated with the CMR, and 18F-FAPI PET/CT could detect a wider range of myocardium than CMR.

Key words: fibroblast activation protein inhibitor, cardiac magnetic resonance, hypertrophic cardiomyopathy

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