First Clinical Application of 99mTc-FAPI-46 as an Available Radiotracer to Evaluate the Cardiac Remodeling Process

We present a 67-year-old woman with a history of coronary artery bypass graft surgery, who experienced recent chest pain. Myocardial perfusion imaging and 99m Tc-FAPI-46 SPECT were performed to assess myocardial infarction. The dynamic FAPI imaging indicated sustained myocardial activity. Myocardial perfusion imaging identified extensive myocardial infarction and ischemia, while FAPI uptake slightly overestimated the infarct extension. Coronary angiography correlated well with these findings. FAPI PET/CT is increasingly being used to monitor cardiac remodeling. This pioneering experience with 99m Tc-FAPI-46 showcases comparable results to PET/CT, providing valuable insights into cardiac remodeling processes and highlighting the potential of 99m Tc-FAPI-46 in cardiac imaging.