18 F-FAPI-04 PET/CT Outperforms 18 F-FDG in Detecting Multiple Muscle and Subcutaneous Adipose Tissue Involvement of Marginal Zone Lymphoma.

Feng, Lijuan; Wang, Hao; Zhang, Wei · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Marginal zone lymphoma (MZL) involving multiple muscles and subcutaneous adipose tissue is extremely rare. We present PET/CT findings of pathologically confirmed MZL with muscle and subcutaneous involvement in a 63-year-old man. 18 F-FAPI-04 PET/CT demonstrated significantly higher radiotracer uptake and better lesion detectability than 18 F-FDG PET/CT in all detectable lesions and, in addition, identified occult right neck muscle involvement not clearly appreciable on 18 F-FDG PET/CT. This case highlights the superiority of 18 F-FAPI-04 PET/CT over 18 F-FDG PET/CT for evaluating MZL with muscle and subcutaneous adipose tissue involvement, especially for mildly FDG-avid lesions.

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