Diagnostic Superiority of 68Ga-FAPI PET/CT Over 18F-FDG in Restaging of Advanced Epithelioid Sarcoma.
case_report · Level V
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- Record sourced from PubMed, PMID 42708192.
- Also identified by DOI 10.1097/RLU.0000000000006685.
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Abstract
We report the case of a 58-year-old man with metastatic epithelioid sarcoma demonstrating an uncommon presentation of expanding tumor volume accompanied by a paradoxically lower SUVmax on 18F-FDG PET/CT. Conversely, 68Ga-FAPI PET/CT demonstrated clear diagnostic superiority, exhibiting intense tracer avidity across established lesions and successfully uncovering multiple new, FDG-occult metastases. This distinct metabolic dissociation highlights a stromal-driven mechanism of tumor invasion. Ultimately, 68Ga-FAPI PET/CT significantly outperforms conventional FDG imaging in delineating total disease burden and detecting clinically occult metastases in this aggressive malignancy.