68 Ga-FAPI-04 PET Differentiates Benign From Malignant in a Patient With 18 F-FDG-Avid Colon Lesion

Area of Science:

• Nuclear medicine
• Oncology
• Gastroenterology

Background:

• Positron emission tomography (PET) using 18F-FDG is crucial for detecting colorectal lesions.
• High 18F-FDG uptake can be observed in both benign and malignant colorectal conditions, requiring further diagnostic evaluation.
• Differentiating between colorectal adenoma and carcinoma preoperatively remains a clinical challenge.

Purpose of the Study:

• To report a case of sigmoid colon tubular adenoma with intense 18F-FDG uptake but negative 68Ga-FAPI-04 PET uptake.
• To highlight the potential role of FAPI PET in distinguishing colorectal adenomas from carcinomas.

Main Methods:

• A 65-year-old male patient underwent PET scans.
• The patient exhibited intense uptake on 18F-FDG PET.
• The patient showed negative uptake on 68Ga-FAPI-04 PET.

Main Results:

• The patient was diagnosed with sigmoid colon tubular adenoma.
• The tubular adenoma demonstrated intense 18F-FDG uptake.
• The same lesion showed negative 68Ga-FAPI-04 PET uptake.

Conclusions:

• This case suggests that FAPI PET may be a valuable tool for preoperative differentiation of colorectal lesions.
• Negative FAPI PET uptake in the presence of high 18F-FDG uptake could suggest a benign adenoma over carcinoma.
• FAPI PET imaging might influence surgical and treatment strategies for colorectal lesions.