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Intense FAPI Uptake of Pancreatic Tissue Can Mask the Tumor Activity of Pancreatic Cancer: The Importance of

Elife Akgün¹, Ahmet Ertuğrul Öztürk¹, Göksel Alçın¹

¹University of Health Sciences Türkiye, İstanbul Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Türkiye.

Molecular Imaging and Radionuclide Therapy

|January 15, 2026

Abstract:

Fibroblast activation protein (FAPI), a type II transmembrane glycoprotein is a promising target to image epithelial originated cancers. Pancreatic cancer is characterized with [⁶⁸Ga]Ga-FAPI-04 and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake in varying degree. However physiologic uptake and uptake associated with acute/chronic pancreatitis makes interpretation challenging. We would like to present a case of pancreatic cancer whose tumor could not delineated from rest pancreatic tissue in [⁶⁸Ga]Ga-FAPI-04 positron emission tomography/computed tomography (PET/CT) images due to intense FAPI uptake in whole pancreas but more remarkable in ¹⁸F-FDG PET/CT images.

Keywords:

FAPI Gallium-68 pancreatic cancer FDG PET/CT

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