Comparison of 68Ga-FAPI and 18F-FDG PET/CT in the Imaging of Pancreatic Cancer With Liver Metastases

A 65-year-old man with suspected pancreatic cancer underwent F-18-FDG PET/CT for initial staging. Mild FDG uptake was observed in the pancreatic mass and bone destruction in the 10th rib on the right. No significant FDG uptake was seen with the multiple hypodense or isodense nodules in the liver. However, Ga-68-FAPI PET/CT revealed intense FAPI uptake in the pancreas and the 10th rib and multiple lesions in the liver. Finally, a biopsy confirmed carcinoma in the head of the pancreas with liver metastasis. This case highlighted that Ga-68-FAPI may outperform F-18-FDG PET/CT in identifying micrometastases of bones and hidden liver metastases.

Automated summary

In a 65-year-old man with suspected pancreatic cancer, Ga-68-FAPI PET/CT showed intense FAPI uptake in the pancreas, 10th rib, and multiple liver lesions, while F-18-FDG PET/CT only showed mild FDG uptake in the pancreas and bone destruction in the rib. Biopsy confirmed carcinoma in the head of the pancreas with liver metastasis, highlighting the potential of Ga-68-FAPI in identifying micrometastases of bones and hidden liver metastases.