FAPI Uptake in Avascular Necrosis of the Talus.

Saber Tanha, Amin; Raeisi, Nasrin; Karamian, Farivash; Jafari Zarrin Ghabaei, Farid; Askari, Emran · Clin Nucl Med · 2026

case_report · Level V

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Abstract

We present a case of metastatic castration-resistant prostate cancer (mCRPC) with prior hepatic involvement who ultimately received 177 Lu-PSMA therapy. During the posttreatment scan following the third cycle, atypical uptake was observed in the left ankle, which was also evident as FAPI uptake on the 68 Ga-FAPI-46 PET/CT performed for restaging, and was subsequently confirmed as avascular necrosis through MRI correlation. This case illustrates the false-positive uptake of 177 Lu-PSMA-617 and 68 Ga-FAPI-46 in avascular necrosis of the talus.

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