Aortic & peripheral vascular disease
Molecular Imaging of Fibroblast Activation Protein on PET/MRI: Association With Carotid-Ulcerated Plaques and Cerebrovascular Risk Factors
Authors' conclusion
68Ga-FAPI-04 positron emission tomography/magnetic resonance imaging identifies FAPI uptake and is associated with ulcerated plaques. FAPI+ plaques are also associated with cerebrovascular risk factors.
Study context
- Population
- Atherosclerotic patients with significant carotid stenosis undergoing 68Ga-FAPI-04 PET/MRI and digital subtraction angiography (DSA) within 1 week82 plaques
- Participants
- 52 patients
- Outcome
- Prevalence, distribution and intensity of fibroblast activation protein (FAP) uptake and its association with carotid ulcerated plaque on DSA and cerebrovascular risk factors
Main finding
As reported in the abstract
- High focal plaque fibroblast activation protein inhibitor (FAPI) uptake (plaques)
- 35 of 82
- Carotid ulcerative plaques among high-uptake plaques
- 18
- FAPI uptake, focal SUVmax and FAPI-derived target-to-background ratio (TBR) greater in ulcerated vs nonulcerated plaques
- all P < 0.001
- FAPI+ uptake independently predicted ulcerated plaques (multivariate)
- P = 0.002
- FAPI-derived TBR independently predicted ulcerated plaques (multivariate)
- P < 0.001
Observational data: associations, not effects.
Further findings
FAPI-derived TBR and cerebrovascular risk factors
- FAPI-derived TBR associated with older age and past cerebrovascular events
- P < 0.001
Per-patient analysis, higher- vs lower-risk patients
- Focal SUVmax greater in higher-risk patients
- P = 0.004
- FAPI-derived TBR greater in higher-risk patients
- P = 0.001
Original publication
Molecular Imaging of Fibroblast Activation Protein on PET/MRI: Association With Carotid-Ulcerated Plaques and Cerebrovascular Risk Factors. JACC Cardiovasc Imaging. Published 6 November 2025. doi:10.
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