More Impressive 18 F-FDG PET/CT Findings Than 68 Ga-DOTA-FAPI-04 in a Cervical Chordoma

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Chordoma is a rare malignant bone tumor originating from notochordal remnants.
• It predominantly affects the axial skeleton, including the cervical spine.
• Accurate imaging is crucial for diagnosis and management of chordoma.

Purpose of the Study:

• To report a case of cervical chordoma in an elderly patient.
• To evaluate the imaging characteristics of chordoma using 18F-FDG PET/CT and 68Ga-DOTA-FAPI-04 PET/CT.
• To investigate the potential utility and limitations of FAPI-targeted PET/CT in chordoma imaging.

Main Methods:

• Case report of an 81-year-old woman with cervical chordoma (C1-C5 vertebrae).
• Positron Emission Tomography/Computed Tomography (PET/CT) imaging was performed.
• Utilized 18F-FDG (fluorodeoxyglucose) and 68Ga-DOTA-FAPI-04 (Fibroblast Activation Protein Inhibitor) tracers.

Main Results:

• The cervical chordoma lesion exhibited intense 18F-FDG uptake.
• Minimal accumulation of 68Ga-DOTA-FAPI-04 was observed in the tumor.
• A discordant imaging pattern was noted between the two PET tracers.

Conclusions:

• FAPI-targeted PET/CT may show heterogeneous uptake in chordoma.
• The tumor microenvironment or specific histologic subtypes might influence FAPI accumulation.
• Further research is needed to clarify the role of FAPI-PET/CT in chordoma diagnosis and characterization.