FAPI-Negative FDG-Avid Metastatic Relapse of Breast Cancer on PET/CT.

Civan, Caner; Has Simsek, Duygu; Isik, Emine Goknur; Sanli, Yasemin; Kuyumcu, Serkan · Clin Nucl Med · 2023

case_report · Level V

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Abstract

A 69-year-old woman with breast cancer underwent 18 F-FDG PET/CT because of the increased CA-15-3 level. 18 F-FDG PET/CT showed multiple hypermetabolic lymph nodes (LNs) in the neck and mediastinum. The patient was also referred for 68 Ga-fibroblast activation protein inhibitor (FAPI) 04 PET/CT for further evaluation. However, 18 F-FDG-avid LNs were FAPI-negative on 68 Ga-FAPI-04 PET/CT. Supraclavicular LN biopsy confirmed the metastasis of breast cancer. Recent reports have focused on the potential of FAPI PET imaging in breast cancer; however, this case highlights that false-negative 68 Ga-FAPI-04-PET/CT findings should also be considered while evaluating metastatic spread.

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