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Positron Emission Tomography

Positron Emission Tomography

Positron emission tomography (PET) is a medical imaging technique involving radiopharmaceuticals — substances that emit short-lived radiation. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential.
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body being...

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18F-FAPI-04 PET/CT Outperforms 18F-FDG in Detecting Multiple Muscle and Subcutaneous Adipose Tissue Involvement of

Lijuan Feng¹, Hao Wang, Wei Zhang

¹Department of Nuclear Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Clinical Nuclear Medicine

|July 7, 2026

Summary

Marginal zone lymphoma (MZL) affecting muscles and fat is rare. 18F-FAPI-04 PET/CT shows superior lesion detection compared to 18F-FDG PET/CT in this specific lymphoma subtype.

Keywords:

FAPI FDG PET/CT marginal zone lymphoma

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Published on: April 25, 2025

Area of Science:

Nuclear Medicine
Oncology
Radiology

Background:

Marginal zone lymphoma (MZL) rarely involves muscle and subcutaneous adipose tissue.
Accurate staging and evaluation of MZL extent are crucial for treatment planning.

Purpose of the Study:

To compare the efficacy of 18F-FAPI-04 PET/CT and 18F-FDG PET/CT in evaluating MZL with muscle and subcutaneous adipose tissue involvement.
To highlight the diagnostic advantages of 18F-FAPI-04 PET/CT in specific MZL cases.

Main Methods:

Case presentation of a 63-year-old male with pathologically confirmed MZL.
Comparison of positron emission tomography/computed tomography (PET/CT) imaging using both 18F-FAPI-04 and 18F-FDG radiotracers.
Pathological confirmation of MZL with muscle and subcutaneous adipose tissue involvement.

Main Results:

18F-FAPI-04 PET/CT demonstrated higher radiotracer uptake and better lesion detectability than 18F-FDG PET/CT in all assessed lesions.
18F-FAPI-04 PET/CT identified occult right neck muscle involvement not clearly visible on 18F-FDG PET/CT.
The study observed superiority of 18F-FAPI-04 PET/CT in evaluating MZL with muscle and subcutaneous adipose tissue involvement, particularly for mildly FDG-avid lesions.

Conclusions:

18F-FAPI-04 PET/CT offers improved diagnostic performance over 18F-FDG PET/CT for marginal zone lymphoma involving muscle and subcutaneous adipose tissue.
This imaging modality is particularly valuable for detecting subtle or mildly FDG-avid lesions in such rare presentations of MZL.
18F-FAPI-04 PET/CT may enhance the accuracy of staging and treatment monitoring for this specific subset of MZL.