Increased 18F-FAPI PET/CT Uptake in a Case of Brucellosis of Lumbar Vertebral Body

A 67-year-old woman presented with dysphagia for 2 months. Enhanced chest CT suggested thickening of the esophageal wall, which was suspected to be a malignancy. The patient then underwent 18F-FDG and 68Ga-FAPI PET/CT. Increased uptake was observed in both tracers in the thickened esophageal wall. However, biopsy demonstrated candida infection of esophagus. After treatment, the symptoms of the patient were relieved.

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confidence: 56%

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confidence: 88%

68Ga-FAPI and 18F-FDG Uptake in a Patient With Esophageal Candida Infection

Chen,

Liu,

Yang

et al. 2023

“…We speculate that the high accumulation of 68 Ga-FAPI-04 in AVM stems from the uptake by the activated fibroblasts. Meanwhile, an increasing number of case studies have reported 68 Ga-FAPI-04 uptake in various nonmalignant etiologies, including myocardial infarction, 6 IgG4-related disease, 7,8 atherosclerotic plaque, 9 xanthogranulomatous cholecystitis, 10 tuberculosis, 11 osteoarthritis, 12 ankylosing spondylitis, 13 and brucellosis 14 . This case indicates that AVM should be considered as one of the differential diagnoses for abnormal 68 Ga-FAPI-04 uptake in the liver.…”

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confidence: 87%

68Ga-FAPI-04 Detected Hepatic Arteriovenous Malformation in a Patient With IgA Nephropathy

Zhang,

Ni,

Guo

et al. 2023

A 51-year-old woman with a history of IgA nephropathy was found to have a mass in the right lobe of the liver by abdominal ultrasound. The PET/CT scan revealed elevated 68Ga-FAPI-04 uptake in the aforementioned lesion, indicating the potential presence of liver cancer. However, subsequent histopathological analysis confirmed it to be an arteriovenous malformation. This case illustrates that 68Ga-FAPI-04 uptake can occur in arteriovenous malformation and is a benign cause of 68Ga-FAPI-04 uptake.

“…However, FAP was also shown to be expressed in many types of nonmalignant bone or joint pathologies including arthritis, 13 fracture, 14 benign bone cyst, 15 fibrous dysplasia, 16 myositis ossificans, 17 avascular necrosis of the bone, 18 Schmorl node, 19 ankylosing spondylitis, 20 bone tuberculosis, 21 and other types of bone infection. 22 Thus, we speculate that sites of SAPHO involvement might be imaged with 68 Ga-DOTA-FAPI-04. The aim of this study is to evaluate the performance of 68 Ga-DOTA-FAPI-04 PET/CT in SAPHO and to compare it with the performance of 18 F-FDG PET/CT.…”

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confidence: 89%

“…Recently, 68 Ga-DOTA-FAPI-04, which targets fibroblast activation protein (FAP), is introduced in tumor imaging. However, FAP was also shown to be expressed in many types of nonmalignant bone or joint pathologies including arthritis, 13 fracture, 14 benign bone cyst, 15 fibrous dysplasia, 16 myositis ossificans, 17 avascular necrosis of the bone, 18 Schmorl node, 19 ankylosing spondylitis, 20 bone tuberculosis, 21 and other types of bone infection 22 . Thus, we speculate that sites of SAPHO involvement might be imaged with 68 Ga-DOTA-FAPI-04.…”

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confidence: 95%

Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT in Patients With SAPHO Syndrome

Wang¹,

Li²,

Hou³

et al. 2023

Purpose Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare inflammatory disorder of bone, joints, and skin, with various stages of bone lesions including inflammation and bone marrow fibrosis. Because the inflammation-induced fibrosis and bone marrow fibrosis are important features in SAPHO syndrome, we undertook a prospective investigation to evaluate whether PET/CT with 68Ga-DOTA-FAPI-04, a novel PET agent targeting fibroblast activation protein, was useful in the evaluation of the patients with SAPHO syndrome. Patients and Methods 68Ga-DOTA-FAPI-04 PET/CT was performed on a cohort of 21 patients with known SAPHO syndrome. All patients underwent 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT on 2 consecutive days. The positive rates of the PET/CT scans at the sites of the osteoarticular symptom, the uptake values, and agreement with clinical osteoarticular symptom were compared. Results A total of 38 sites of involvement were detected. 18F-FDG PET/CT revealed 28 lesions. In contrast, 68Ga-DOTA-FAPI-04 PET/CT detected not only all lesions shown on 18F-FDG PET/CT but additional 10 lesions. 68Ga-DOTA-FAPI-04 scan also demonstrated significantly higher uptake and target-to-background ratio than 18F-FDG studies in the skeletal involvements. The agreement between 68Ga-DOTA-FAPI-04–positive lesions and current osteoarticular lesions was substantial (κ = 0.79, P < 0.001), whereas 18F-FDG had low to moderate agreement with clinical symptoms (κ = 0.52, P < 0.001). Conclusions 68Ga-DOTA-FAPI-04 has potential as a promising imaging agent for the evaluation of SAPHO syndrome.