Cardiovascular PET imaging of fibroblast activation A review of the current literature

Krithika Loganath; Neil Craig; Anna Barton; Shruti Joshi; Constantinos Anagnostopoulos; Paola Anna Erba; Andor W J M Glaudemans; Antti Saraste; Jan Bucerius; Mark Lubberink; Olivier Gheysens; Ronny R Buechel; Gilbert Habib; Oliver Gaemperli; Alessia Gimelli; Fabien Hyafil; David E Newby; Riemer H J A Slart; Marc R Dweck

doi:10.1016/j.nuclcard.2024.102106

Cardiovascular PET imaging of fibroblast activation A review of the current literature

J Nucl Cardiol. 2024 Dec 11:102106. doi: 10.1016/j.nuclcard.2024.102106. Online ahead of print.

Authors

Krithika Loganath¹, Neil Craig², Anna Barton², Shruti Joshi², Constantinos Anagnostopoulos³, Paola Anna Erba⁴, Andor W J M Glaudemans⁵, Antti Saraste⁶, Jan Bucerius⁷, Mark Lubberink⁸, Olivier Gheysens⁹, Ronny R Buechel¹⁰, Gilbert Habib¹¹, Oliver Gaemperli¹², Alessia Gimelli¹³, Fabien Hyafil¹⁴, David E Newby², Riemer H J A Slart¹⁵, Marc R Dweck²

Affiliations

¹ BHF Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom. Electronic address: [email protected].
² BHF Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
³ Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
⁴ Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy; Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁵ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶ Turku PET Centre, Turku University Hospital and University of Turku, Kiinamllynkatu, Turku, Finland; Heart Center, Turku University Hospital, Turku, Finland.
⁷ Department of Nuclear Medicine, Georg-August University Göttingen, University Medicine Göttingen, Göttingen, Germany.
⁸ Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden.
⁹ Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
¹⁰ Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
¹¹ Cardiology Department, APHM, La Timone Hospital, Marseille, France; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.
¹² HeartClinic, Hirslanden Hospital Zurich, Hirslanden, Switzerland.
¹³ Fondazione Toscana G. Monasterio, Pisa, Italy.
¹⁴ Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France; PARCC, INSERM, University of Paris, Paris, France.
¹⁵ Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Faculty of Science and Technology Biomedical, Photonic Imaging, University of Twente, Enschede, The Netherlands.

PMID: 39672296
DOI: 10.1016/j.nuclcard.2024.102106

Abstract

Fibrosis is one of the key healing responses to injury, especially within the heart where it helps to maintain structural integrity following acute insults such as myocardial infarction. However, if it becomes dysregulated then fibrosis can become maladaptive leading to adverse remodelling, impaired cardiac function and heart failure. Fibroblast activation protein is exclusively expressed by activated fibroblasts, the key effector cells of fibrogenesis, and has a unique extracellular domain that is an ideal ligand for novel molecular imaging probes. Fibroblast activation protein inhibitor (FAPI) radiotracers have been developed for PET imaging, demonstrating high selectivity for activated fibroblasts across a range of different pathologies and disparate organ systems. In this review, we will summarize the role of fibroblast activation protein in cardiovascular disease and how FAPI radiotracers might improve the assessment and treatment of patients with cardiovascular diseases.

Keywords: Cardiac Computed Tomography; Cardiac magnetic resonance; Fibroblast; Fibroblast activation protein inhibitor (FAPI); Positron Emission Tomography.

Publication types

Review