Enhancing Clinical Diagnosis for Patients With Persistent Pulmonary Abnormalities After COVID-19 Infection The Potential Benefit of 68Ga-FAPI PET/CT

Coronavirus disease 2019 (COVID-19)-related pneumonia challenges clinical practice. We explore the potential diagnostic benefit of PET/CT to establish the underlying inflammatory or fibrotic repair processes in prolonged structural lung abnormalities in COVID-19 patients. Patients and Methods Six post COVID-19 patients suspected for pulmonary fibrosis were scheduled for dual-tracer PET/CT with F-18-FDG and Ga-68-fibroblast activation protein inhibitor (FAPI)-46. The uptake of Ga-68-FAPI-46 in the involved lung was compared with a control group of 9 non-COVID-19 patients. Clinical data and PET/CT imaging were collected and analyzed. Results PET/CT revealed in all 6 pulmonary impaired patients the reduced glucose avidity on F-18-FDG and clear positivity on Ga-68-FAPI-46 PET/CT in comparison to the control group. Conclusions Enhancing fibrotic repair mechanisms, Ga-68-FAPI PET/CT may improve noninvasive clinical diagnostic performance in patients with long-term CT abnormalities after severe COVID-19. Although this study shows promising results, additional studies in larger populations are required to establish a general diagnostic guideline.

Automated summary

This study explores the potential diagnostic benefit of PET/CT in identifying the underlying inflammatory or fibrotic repair processes in COVID-19 patients with prolonged lung abnormalities. The results show that Ga-68-FAPI-46 PET/CT had clear positivity in six pulmonary impaired patients, while F-18-FDG showed reduced glucose avidity compared to the control group.