Elevated 68Ga-FAPI Accumulation in a Recurrent Angiomyolipoma.

Area of Science:

• Nuclear Medicine
• Oncology
• Radiomics

Background:

• Gallium-68 fibroblast activation protein inhibitor (Ga-FAPI) positron emission tomography (PET) imaging is a novel diagnostic tool for various malignant tumors.
• Limited data exists on the application of FAPI imaging in the evaluation of benign tumors.

Observation:

• A 53-year-old woman presented with a recurrent retroperitoneal angiomyolipoma.
• The tumor exhibited low Fluorodeoxyglucose (F-FDG) uptake on PET imaging.
• Ga-FAPI PET revealed diffuse, heterogeneous, and intense uptake in the tumor, with suspected lung metastases.

Findings:

• Ga-FAPI PET imaging demonstrated significant uptake in a pathologically confirmed benign angiomyolipoma.
• The imaging findings suggest FAPI's potential utility in identifying fibrotic activity characteristic of certain benign conditions.
• Suspected lung metastases were also identified, warranting further investigation.

Implications:

• This case highlights the potential of Ga-FAPI PET imaging beyond malignant diagnoses, extending its utility to benign tumors with significant fibrotic components.
• FAPI imaging may serve as a valuable tool for diagnosing and staging benign conditions characterized by fibroblast activation.
• Further research is warranted to explore the role of FAPI PET in a broader range of benign diseases.