Increased 68Ga-FAPI Uptake of Symptomatic Intracranial Atherosclerotic Plaque Revealed by PET/MR.

A 58-year-old man was enrolled in our 68Ga-FAPI PET/MR study for evaluation of stroke etiology. He had left thalamus and cerebellum infarction 6 months ago, and left occipital lobe infarction 2 years ago. 68Ga-FAPI PET/MR showed focal uptake along the low segment of the basilar artery. We hypothesize that the FAPI-avid plaque of basilar artery may account for the embolic events resulting in downstream infarction. Thus FAP-targeted imaging may have a potential for detection of vulnerable plaques.