Intense fibroblast activation protein inhibitor localization around the site of embolized gastroduodenal artery in a patient with metachronous pancreatic adenocarcinoma: A potential pitfall in positron imaging

Abstract

68Gallium-Fibroblast activation protein inhibitor (68Ga-FAPI) positron emission tomography/computed tomography (PET/CT) is increasingly used for evaluating various epithelial neoplasms. Despite addressing some pitfalls, many remain unacknowledged. This report details a 77-year-old man with suspected pancreatic malignancy who underwent a 68Ga-FAPI PET/CT scan post-gastroduodenal coil embolization for upper gastrointestinal bleeding. The scan revealed intense 68Ga-FAPI uptake in the pancreatic body and tail malignancy and around the embolized gastroduodenal artery, indicating a healing process. This highlights the importance of understanding FAPI expression in recent surgical sites for accurate radiologic interpretation.