Diagnostic Superiority of 68 Ga-FAPI PET/CT Over 18 F-FDG in Restaging of Advanced Epithelioid Sarcoma.

Clin Nucl MedSep 8, 2026 (epub)
Case ReportNuclear MedicineOncology (Medical)

Faeze Rabani, Haniye Elahifard, Amin Saber Tanha et al.

✦ AI-curated · Sources linked

Case in brief

A 58-year-old man with metastatic epithelioid sarcoma underwent restaging with 18F-FDG and 68Ga-FAPI PET/CT. Despite expanding tumor volume, established lesions showed a paradoxically lower maximum SUV on FDG imaging. FAPI PET/CT showed intense uptake in known lesions and identified multiple metastases not visible on FDG imaging, providing a clearer delineation of disease burden. The report describes this discordance as a metabolic dissociation and suggests a stromal-driven mechanism of tumor invasion.

What made this case unusual

Tumor volume expanded while FDG maximum SUV fell, whereas FAPI imaging showed intense uptake and revealed multiple FDG-occult metastases.

Diagnostic / clinical pearl

In this case of metastatic epithelioid sarcoma, a lower FDG SUV despite increasing tumor volume did not reflect the full disease burden; FAPI PET/CT detected additional occult lesions.

Source

PubMed · PMID 42708192

Published in Clin Nucl Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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