68Ga-FAPI PET/CT Provides a Clear Picture of a Klatskin Tumor That 18F-FDG PET/CT Missed

Abstract

Klatskin tumor, also known as hilar cholangiocarcinoma, was clearly demonstrated in this case report by contrasting 68Ga-FAPI and 18F-FDG PET/CT in the same patient. This instance exemplifies a false-negative 18F-FDG PET/CT for the main tumor site, despite positive 68Ga-FAPI uptake at the same location.

Fibroblast Activation Protein Inhibitor Theranostics: A Huge Opportunity with its Fair Share of Oncological Pitfalls

“…Studies have shown that FAPI PET imaging is particularly superior to FDG for detecting tumors with a strong desmoplastic reaction, such as breast, colon, hepatobiliary, gastrointestinal, pancreatic, sarcomatous, and rare neoplasms, making it a potential rival to FDG imaging in several lethal cancer subtypes. 7 8 9 Ongoing research will continue to explore the potential of FAPI imaging in various cancer subtypes, and clinical trials are being conducted to assess its safety and efficacy as a therapeutic tool in the coming years. 10 …”

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“…Studies have shown that FAPI PET imaging is particularly superior to FDG for detecting tumors with a strong desmoplastic reaction, such as breast, colon, hepatobiliary, gastrointestinal, pancreatic, sarcomatous, and rare neoplasms, making it a potential rival to FDG imaging in several lethal cancer subtypes. [7][8][9] Ongoing research will continue to explore the potential of FAPI imaging in various cancer subtypes, and clinical trials are being conducted to assess its safety and efficacy as a therapeutic tool in the coming years. 10 Despite their potential benefits, FAPI imaging faces inherent challenges and limitations.…”

68Ga-FAPI PET/CT Imaging

“…Cholangiocarcinoma has been studied previously using 68 Ga-FAPI PET/CT and was found to have a high 68 Ga-FAPI avidity, exceeding SUV max values of 12. 1,2 A recent retrospective study analyzed a group of 19 patients with pancreatic adenocarcinoma and found that 68 Ga-FAPI was successful in differentiating benign from malignant disease using differential uptake kinetics. 3 In addition, 68 Ga-FAPI PET/CT was found to be superior to conventional imaging modalities in restaging and detecting recurrent disease in half of the patients.…”

“…The SUV max was calculated for the primary tumor site and found to be 14.7. Cholangiocarcinoma has been studied previously using 68 Ga-FAPI PET/CT and was found to have a high 68 Ga-FAPI avidity, exceeding SUV max values of 12 1,2 . A recent retrospective study analyzed a group of 19 patients with pancreatic adenocarcinoma and found that 68 Ga-FAPI was successful in differentiating benign from malignant disease using differential uptake kinetics 3 .…”