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Elevated FAPI Activity in an Adult Brodie Abscess

Yang Xie1, Wenxin Tang, Huipan Liu

  • 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
|February 20, 2024
PubMed

Insights

Brodie abscess can mimic bone metastasis on imaging. Elevated uptake of 18F-FDG and 68Ga-FAPI in osteolytic lesions suggests considering Brodie abscess in differential diagnoses.

Area of Science:

  • Medical Imaging
  • Oncology
  • Orthopedics

Background:

  • Brodie abscess is a subacute osteomyelitis typically presenting with vague symptoms.
  • Osteolytic lesions can be challenging to differentiate from bone metastases using conventional imaging.
  • Fibroblast activating protein inhibitor (FAPI) imaging is emerging for various pathologies.

Purpose of the Study:

  • To report a case of Brodie abscess mimicking bone metastasis.
  • To highlight the utility of 18F-FDG and 68Ga-FAPI PET/CT in diagnosing challenging osteolytic lesions.
  • To emphasize the importance of including Brodie abscess in the differential diagnosis.

Main Methods:

  • Case report of an adult patient with an osteolytic lesion.
  • Utilized 18F-FDG PET/CT and 68Ga-FAPI PET/CT for diagnostic imaging.
  • Compared imaging findings with histopathological results.

Main Results:

  • The Brodie abscess demonstrated elevated uptake of both 18F-FDG and 68Ga-FAPI.
  • The imaging findings mimicked those of bone metastasis.
  • Histopathology confirmed Brodie abscess.

Conclusions:

  • Brodie abscess can present with imaging characteristics similar to bone metastases.
  • 68Ga-FAPI PET/CT may show increased uptake in Brodie abscess, aiding in differential diagnosis.
  • Consider Brodie abscess in the differential diagnosis of osteolytic lesions with increased 68Ga-FAPI uptake.

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