Intense 68 Ga-FAPI-04 Uptake in a Rare Case of Multifocal Abdominal Wall Endometriosis
Dilruba Şahin1, Hatice Uslu1, Meryem Hocaoğlu2
1Department of Nuclear Medicine.
Clinical Nuclear Medicine
|January 16, 2026
Summary
Fibroblast activation protein inhibitor (FAPI) PET/CT effectively detected abdominal wall endometriosis (AWE) and adenomyosis, showing intense tracer uptake. This imaging approach shows promise for identifying endometriosis in unusual locations.
Area of Science:
- Molecular imaging
- Nuclear medicine
- Gynecologic pathology
Background:
- Abdominal wall endometriosis (AWE) is rare, involving ectopic endometrial tissue.
- Current imaging methods have limitations in detecting atypically located endometriosis.
Purpose of the Study:
- To evaluate the utility of 68Ga-FAPI-04 PET/CT in diagnosing abdominal wall endometriosis.
- To highlight the potential of FAPI PET for detecting endometriosis in non-traditional locations.
Main Methods:
- Case presentation of a patient with biopsy-confirmed endometriosis.
- Utilized 68Ga-FAPI-04 PET/CT for molecular imaging.
- Compared FAPI uptake with FDG uptake in identified lesions.
Main Results:
- 68Ga-FAPI-04 PET/CT revealed extensive multifocal AWE and adenomyosis.
- Lesions showed intense FAPI uptake.
- FDG uptake was low or absent in these endometriosis lesions.
Conclusions:
- FAPI PET/CT demonstrates significant potential for detecting atypically located endometriosis.
- This modality offers an advantage over conventional imaging for endometriosis diagnosis in challenging cases.
