Case report reveals intense FAPI uptake masks tumor activity in pancreatic cancer, suggesting need for dual-tracer imaging.
Fibroblast activation protein (FAPI), a type II transmembrane glycoprotein is a promising target to image epithelial originated cancers. Pancreatic cancer is characterized with [⁶⁸Ga]Ga-FAPI-04 and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake in varying degree. However physiologic uptake and uptake associated with acute/chronic pancreatitis makes interpretation challenging. We would like to present a case of pancreatic cancer whose tumor could not delineated from rest pancreatic tissue in [⁶⁸Ga]Ga-FAPI-04 positron emission tomography/computed tomography (PET/CT) images due to intense FAPI uptake in whole pancreas but more remarkable in ¹⁸F-FDG PET/CT images.
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Akgün et al. (2026) studied this question.
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