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Arterial wall FAP inhibitor (FAPI) uptake in major vessel segments was evaluated. We then investigated the associations of arterial wall uptake with calcified plaque burden (including number of plaques, plaque thickness, and calcification circumference), CVRFs, FAP-positive total tumor burden, and image noise (coefficient of variation, from normal liver parenchyma).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>High focal arterial FAPI uptake (FAPI\u2009+) was recorded in 64\/69 (92.8%) scans in 800 sites, of which 377 (47.1%) exhibited concordant vessel wall calcification. The number of FAPI\u2009+\u2009sites per patient and (FAPI\u2009+)-derived target-to-background ratio (TBR) correlated significantly with the number of calcified plaques (FAPI\u2009+\u2009number: <jats:italic>r<\/jats:italic>\u2009=\u20090.45, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; TBR: <jats:italic>r<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.26, <jats:italic>P<\/jats:italic>\u2009=\u20090.04), calcified plaque thickness (FAPI\u2009+\u2009number: <jats:italic>r<\/jats:italic>\u2009=\u20090.33, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; TBR: <jats:italic>r<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.29, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), and calcification circumference (FAPI\u2009+\u2009number: <jats:italic>r<\/jats:italic>\u2009=\u20090.34, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; TBR: <jats:italic>r<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.26, <jats:italic>P<\/jats:italic>\u2009=\u20090.04). In univariate analysis, only body mass index was significantly associated with the number of FAPI\u2009+\u2009sites (<jats:italic>OR<\/jats:italic> 1.06; 95% CI, 1.02\u2009\u2212\u20091.12, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). The numbers of FAPI\u2009+\u2009sites and FAPI\u2009+\u2009TBR, however, were not associated with other investigated CVRFs in univariate and multivariate regression analyses. Image noise, however, showed significant correlations with FAPI\u2009+\u2009TBR (<jats:italic>r<\/jats:italic>\u2009=\u20090.30) and the number of FAPI\u2009+\u2009sites (<jats:italic>r<\/jats:italic>\u2009=\u20090.28; <jats:italic>P<\/jats:italic>\u2009=\u20090.02, respectively). In addition, there was no significant interaction between FAP-positive tumor burden and arterial wall FAPI uptake (<jats:italic>P<\/jats:italic>\u2009\u2265\u20090.13).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>[<jats:sup>68<\/jats:sup>\u00a0Ga]Ga-FAPI-04 PET identifies arterial wall lesions and is linked to marked calcification and overall calcified plaque burden, but is not consistently associated with cardiovascular risk. Apparent wall uptake may be partially explained by image noise.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-023-06245-w","type":"journal-article","created":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T02:01:27Z","timestamp":1683338487000},"page":"3011-3021","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Molecular imaging of arterial fibroblast activation protein: association with calcified plaque burden and cardiovascular risk factors"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9313-9356","authenticated-orcid":false,"given":"Aleksander","family":"Kosmala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian E.","family":"Serfling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Michalski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lindner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schirbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp E.","family":"Hartrampf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Derlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas K.","family":"Buck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Weich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"6245_CR1","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1016\/j.ajpath.2020.01.004","volume":"190","author":"J Monslow","year":"2020","unstructured":"Monslow J, Todd L, Chojnowski JE, Govindaraju PK, Assoian RK, Pure E. 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The need for further ethical review and approval were waived by the local Ethics Committee due to the retrospective character of the study (waiver no. 20210415 02).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Procedures were performed as part of clinical care. Informed consent was obtained from all subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"TL is a co-inventor of a patent application for quinolone-based FAP-targeting agents for imaging and therapy in nuclear medicine. TL also has shares of a consultancy group for iTheranostics. All other authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}