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Yoo Jin Lee, MD
UCSF
Bracco Diagnostics Inc./RSNA Research Scholar Grant
(2022 - 2024)
Imaging of Active Myocardial Fibrosis Using 68 Ga-FAP-2286
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Abstract:
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Adverse myocardial remodeling including the deposition of extracellular matrix proteins and collagen by cardiac fibroblasts is a hallmark of heart failure progression and common sequelae of most varieties of cardiovascular disease. Despite the importance of early detection of myocardial fibrosis, we have no reliable imaging technique of early fibroblast activity prior to inducing overt myocardial scar that is not confounded by myocardial edema. Fibroblast activation protein (FAP) is a specific marker of activated fibroblasts, which can be visualized by positron emission tomography (PET) using Gallium 68 (68Ga)-labeled radioligands such as 68Ga-FAP-2286. The original work with FAP-targeted PET agents focused on the staging of patients with cancer, by imaging cancer-associated fibroblasts. The role of FAP PET in non-oncologic fibrosis remains less explored. We propose to evaluate active fibroblast activity in both murine models and human patients using 68Ga-FAP PET/CT. We will scan two murine model lines of cardiac fibrosis using FAP PET: acute myocardial infarction caused by ligation of the coronary artery and hypertrophic cardiomyopathy model carrying a gene mutation. Finally, we will image human patients with Myocardial Infarction and Hypertrophic Cardiomyopathy with 68Ga-FAP-2286 PET/CT and compare them to Cardiac MRI for evaluation of myocardial fibrosis. The work outlined in this proposal to ultimately differentiate active versus chronic myocardial fibrosis will lay the foundation for an enhanced understanding of cardiac pathophysiology and will provide critical information for patient treatment.
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