Increased 68 Ga-FAPI-04 Uptake in Cerebral Infarction

Area of Science:

• Nuclear medicine
• Oncologic imaging
• Neuroimaging

Background:

• Fibroblast activation protein (FAPI) PET/CT is emerging as a valuable tool for brain tumor assessment.
• Its high target-to-background ratio and low uptake in normal brain parenchyma support its utility.
• However, FAPI uptake is also observed in nonmalignant brain conditions, posing diagnostic challenges.

Purpose of the Study:

• To report the 68Ga-FAPI-04 PET/CT findings in a patient with chronic hemorrhagic occipital infarction.
• To illustrate the potential for FAPI uptake to mimic malignancy in nonmalignant brain lesions.

Main Methods:

• A case study describing the PET/CT findings in a patient with chronic hemorrhagic occipital infarction.
• Utilized 68Ga-FAPI-04 as the radiotracer for PET/CT imaging.

Main Results:

• The infarcted area in the patient's occipital lobe exhibited inhomogeneous 68Ga-FAPI-04 uptake.
• This uptake pattern mimicked the appearance of a malignant lesion on PET/CT scans.

Conclusions:

• Chronic brain infarction can present as a FAPI-avid lesion on PET/CT imaging.
• Brain infarction should be considered in the differential diagnosis of FAPI-avid brain lesions to avoid misdiagnosis of malignancy.