Abnormal adnexal uptake in ⁶⁸Ga-FAPI PET/CT: from physiological variants to malignant characterization.

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Adnexal imaging in females is complicated by the menstrual cycle.
• Accurate diagnosis of adnexal lesions is critical for effective tumor treatment.

Purpose of the Study:

• To assess the clinical utility of abnormal adnexal uptake on ⁶⁸Ga-FAPI PET/CT for early and precise lesion characterization.

Main Methods:

• Retrospective analysis of 121 female patients with abnormal adnexal uptake on ⁶⁸Ga-FAPI PET/CT.
• Semiquantitative analysis of PET/CT parameters, serum tumor markers, and immunohistochemical markers.
• Pathology or ≥6-month imaging follow-up as the gold standard.

Main Results:

• 184 adnexal lesions identified; 82.6% confirmed as malignancies.
• Significant differences in SUVmax between malignant and benign lesions (p<0.001).
• SUVmax correlated with Ki-67 and p53, with higher SUVmax in Ki67 >20% group (p<0.001).
• Area under the curve (AUC) for SUVmax alone was 0.85, increasing to 0.89 when combined with tumor markers.

Conclusions:

• ⁶⁸Ga-FAPI PET/CT exhibits high diagnostic performance for adnexal lesions.
• SUVmax correlates with proliferative activity and malignant potential in confirmed cases.
• ⁶⁸Ga-FAPI PET/CT supports diagnostic optimization for adnexal lesions.