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Updated: Sep 28, 2025

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Schmorl Node Can Cause Increased 68Ga-FAPI Activity on PET/CT.

Junhao Wu1, Wenxin Tang, Yingwei Wang

  • 1From the Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; and Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China.

Clinical Nuclear Medicine
|March 30, 2022
PubMed
Summary
This summary is machine-generated.

68Ga-FAPI PET/CT scans can show false positives. Schmorl nodes, benign lesions, may incorrectly appear as tumors due to increased FAPI activity, requiring careful interpretation.

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceuticals

Background:

  • Fibroblast Activation Protein (FAPI) targeted imaging agents, such as 68Ga-FAPI, are emerging tools for tumor detection.
  • While effective, these agents can exhibit uptake in non-malignant tissues, potentially leading to misdiagnosis.
  • Understanding benign sources of FAPI activity is crucial for accurate PET/CT interpretation.

Purpose of the Study:

  • To report the incidental finding of 68Ga-FAPI uptake in a Schmorl node.
  • To highlight Schmorl nodes as a potential cause of false-positive results in 68Ga-FAPI PET/CT imaging.
  • To increase awareness among clinicians regarding this differential diagnosis.

Main Methods:

  • Case report of a patient undergoing 68Ga-FAPI PET/CT for sweat gland cancer.
  • Observation of unexpected focal radiotracer accumulation in a spinal lesion.
  • Histopathological correlation to identify the nature of the lesion.

Main Results:

  • The patient exhibited increased 68Ga-FAPI uptake in a lesion consistent with a Schmorl node.
  • This finding was confirmed as benign upon further investigation.
  • The Schmorl node demonstrated significant FAPI expression.

Conclusions:

  • Schmorl nodes can exhibit FAPI activity, mimicking malignant lesions on 68Ga-FAPI PET/CT.
  • This necessitates careful consideration of Schmorl nodes in the differential diagnosis of unexpected 68Ga-FAPI uptake.
  • Increased awareness can prevent misinterpretation and unnecessary patient anxiety or interventions.