A 65-year-old man with suspected pancreatic cancer underwent 18F-FDG PET/CT for initial staging. Mild FDG uptake was observed in the pancreatic mass and bone destruction in the 10th rib on the right. No significant FDG uptake was seen with the multiple hypodense or isodense nodules in the liver. However, 68Ga-FAPI PET/CT revealed intense FAPI uptake in the pancreas and the 10th rib and multiple lesions in the liver. Finally, a biopsy confirmed carcinoma in the head of the pancreas with liver metastasis. This case highlighted that 68Ga-FAPI may outperform 18F-FDG PET/CT in identifying micrometastases of bones and hidden liver metastases.

Two men with metastatic paraganglioma/pheochromocytoma underwent PET/CT examination in our hospital to understand the treatment effect and progression of the disease. Both patients had previously been treated with 131I-MIBG, and at this evaluation, both of them underwent 68Ga-DOTATATE and 18F-MFBG PET/CT. The 68Ga-DOTATATE PET/CT showed more metastases in the images of these 2 patients. This case highlighted that 68Ga-DOTATATE PET/CT is superior to 18F-MFBG PET/CT in detecting metastases from paraganglioma and pheochromocytoma in these 2 patients.