68 Ga-FAPI-04 PET/CT Demonstrates Subtype-specific Uptake Patterns in Endometriosis With Added Diagnostic Value...

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology
• Gynecology

Background:

• Endometriosis is a chronic inflammatory condition affecting women of reproductive age.
• Accurate staging and characterization of endometriosis, especially deep infiltrating endometriosis (DIE), remain challenging.
• Current imaging modalities like MRI have limitations in detecting all endometriotic lesions.

Purpose of the Study:

• To evaluate the diagnostic performance of 68Ga-FAPI-04 PET/CT in patients with biopsy-proven endometriosis.
• To compare FAPI PET/CT findings with MRI in detecting and characterizing endometriotic lesions.
• To explore subtype-specific uptake patterns of 68Ga-FAPI-04 in different endometriosis manifestations.

Main Methods:

• A single case study of a 44-year-old woman with biopsy-proven endometriosis.
• Performance of Magnetic Resonance Imaging (MRI) for pelvic evaluation.
• Administration and PET/CT imaging using 68Ga-FAPI-04.
• Surgical confirmation of detected lesions.

Main Results:

• 68Ga-FAPI-04 PET/CT showed concordant uptake in known deep infiltrating lesions and intense uptake in adenomyosis, correlating with MRI findings.
• FAPI PET/CT identified an additional sigmoid-rectal junction lesion, not seen on MRI, which was surgically confirmed as bowel endometriosis.
• Distinct uptake patterns were observed: highest in adenomyosis, high to moderate in DIE, and mild in ovarian endometriomas.

Conclusions:

• 68Ga-FAPI-04 PET/CT demonstrates complementary diagnostic value in evaluating endometriosis, particularly for deep infiltrating and bowel involvement.
• The imaging technique offers potential for improved detection and characterization of endometriosis subtypes.
• FAPI PET/CT may aid in surgical planning and management of complex endometriosis cases.