More Impressive 18 F-FDG PET/CT Findings Than 68 Ga-DOTA-FAPI-04 in a Cervical Chordoma.

Xu, Tingting; Cheng, Ke; Liu, Ya; Chen, Yue · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Chordoma is a rare malignant bone tumor derived from notochordal remnants, typically occurring in the axial skeleton. Herein, we report a case of an 81-year-old woman with a cervical chordoma involving the C1-C5 vertebrae. The lesion demonstrated intense 18 F-FDG uptake but minimal 68 Ga-DOTA-FAPI-04 accumulation. This discordant imaging pattern highlights that while FAPI-targeted PET/CT is a promising pan-cancer imaging modality, its uptake in chordoma may be heterogeneous, potentially influenced by the tumor microenvironment or specific histologic subtypes.

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