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18F-FXA is a radiopharmaceutical positron emission tomography (PET) tracer specifically designed for the non-invasive imaging of activated Factor X (Factor Xa), a key enzyme in the blood coagulation cascade. Developed primarily by researchers at Stanford University, the tracer is a small molecule derivative of a Factor Xa inhibitor labeled with the radioactive isotope fluorine-18. By binding with high affinity to the catalytic active site of Factor Xa, which is highly concentrated at the surface of active thrombi, 18F-FXA allows for the precise localization and visualization of acute thromboembolic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE). This functional imaging approach potentially offers a significant advantage over traditional anatomical imaging (like ultrasound or CT) by distinguishing active, growing clots from older, stable, or organized fibrin deposits, thereby assisting in the diagnosis and management of acute thrombosis.
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