⁶⁸Ga-FAPI PET/CT safely detects multifocal endometriosis: a case report

Area of Science:

• Molecular imaging
• Nuclear medicine
• Gynecologic imaging

Background:

• Endometriosis diagnosis is challenging, often missing multifocal lesions with standard imaging.
• Fibroblast Activation Protein (FAP) is a target for molecular imaging in fibrotic conditions.

Purpose of the Study:

• To evaluate the efficacy of 68Ga-FAPI-46 PET/CT in detecting multifocal endometriosis.
• To assess the safety and diagnostic accuracy of this novel imaging modality compared to conventional methods.

Main Methods:

• A case study involving a 28-year-old woman with suspected endometriosis.
• Comparison of transvaginal ultrasound (TVS), pelvic MRI, and 68Ga-FAPI-46 PET/CT.
• Radiation dosimetry using Monte Carlo simulations to determine organ doses.

Main Results:

• 68Ga-FAPI-46 PET/CT identified a known ovarian endometrioma and two additional, previously undetected nodules.
• Conventional imaging (TVS, MRI) missed these additional lesions.
• Surgical pathology confirmed multifocal endometriosis, validating PET/CT findings. Low radiation dose confirmed safety.

Conclusions:

• 68Ga-FAPI-46 PET/CT is a safe and effective tool for detecting occult endometriosis.
• This molecular imaging technique can reveal lesions missed by standard ultrasound and MRI.
• Further research with larger cohorts is warranted to establish its role in routine clinical practice.