Enhanced Detection of Recurrent Diffuse Malignant Peritoneal Mesothelioma Using 68 Ga-FAPI PET/CT Compared to 18
Marwah Abdulrahman1, Ula Al-Rasheed1, Ali Dabous2
1Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan.
Abstract:
Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and aggressive subtype of epithelioid mesothelioma that arises from the lining of the abdominal cavity. While the applications of traditional fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in diagnosis and staging of DMPM are well-established, the utility of gallium-68 fibroblast activating protein inhibitor ( 68 Ga-FAPI) PET/CT in detecting disease recurrence remains an area that requires further research and validation, with limited literature. Implementing FAPI PET/CT for these cases may provide superior lesion detectability and higher reporter confidence, prompting the need for further studies to investigate the potential future role of FAPI theranostics in guiding treatment decisions for DMPM. This case report describes a 49-year-old male patient diagnosed with DMPM, who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy but developed recurrent disease that was better visualized on 68 Ga-FAPI PET/CT compared with 18 F-FDG PET/CT.
Insights
Gallium-68 fibroblast activating protein inhibitor (68Ga-FAPI) PET/CT shows promise for detecting recurrent diffuse malignant peritoneal mesothelioma (DMPM). This imaging technique may offer superior visualization compared to standard 18F-FDG PET/CT.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Diffuse malignant peritoneal mesothelioma (DMPM) is a rare, aggressive cancer.
- Standard 18F-FDG PET/CT is established for DMPM diagnosis and staging.
- The role of 68Ga-FAPI PET/CT in detecting DMPM recurrence needs further investigation.
Observation:
- A case report details a 49-year-old male with DMPM treated with surgery and chemotherapy.
- The patient developed recurrent disease after initial treatment.
- Recurrent DMPM was more clearly visualized using 68Ga-FAPI PET/CT than 18F-FDG PET/CT.
Findings:
- 68Ga-FAPI PET/CT demonstrated superior lesion detectability for recurrent DMPM.
- This suggests FAPI-based imaging may enhance diagnostic confidence in DMPM recurrence.
- Limited literature currently exists on 68Ga-FAPI PET/CT for DMPM recurrence.
Implications:
- 68Ga-FAPI PET/CT could potentially improve the detection of DMPM recurrence.
- Further research is warranted to validate its utility and explore FAPI theranostics for DMPM treatment guidance.
- This imaging modality may offer a future role in personalized DMPM management.
