Why the study?
The role of 68Ga FAPI-04 imaging in non-oncological indications, especially in myocardial ischemia and fibrosis, is still evolving.
Case Report (n=1)
No
68Ga FAPI-04 PET/CT can incidentally detect myocardial fibrosis and severe coronary stenosis, correlating well with perfusion imaging, doppler flow velocity, and angiography.
Incidental CAD detection on FAPI PET/CT is feasible in case reports; leaves open its diagnostic role pending prospective validation.
68 Ga Fibroblast Activation Protein Inhibitor 04 (FAPI-04) is a radiolabelled molecular agent targeting the fibroblast activation protein (FAP). It is highly expressed on cancer-associated fibroblasts in the tumor stroma and at very low levels expressed throughout the body. Its role in inflammatory conditions is based on fibroblast proliferation. Its use has been well established in many oncological settings, while its role in non-oncological indications, especially in myocardial ischemia and fibrosis, is still evolving. We present an incidental finding of myocardial fibrosis (chronic infarct) in an unsuspected left anterior descending artery (LAD) stenosis on 68 Ga FAPI-04 imaging in a patient under evaluation for a solitary pulmonary nodule. This finding was later correlated with 99mTc SestaMIBI SPECT, doppler sampling of coronary artery velocities and finally coronary angiogram.
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Sundaram et al. (2026) conducted a case report in Severe LAD stenosis (n=1). 68Ga FAPI-04 PET/CT was evaluated on Detection of myocardial fibrosis and LAD stenosis.
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