FAPI-avid Lesions in the Brain

A 63-year-old man presented with transient global amnesia, urinary incontinence, and a visual field deficit. MRI revealed a heterogeneous mass in the left parieto-occipital lobe, diagnosed as glioblastoma multiforme (GBM). Following craniotomy, chemotherapy with temozolomide and radiotherapy were initiated. Two months after radiotherapy, MRI indicated possible tumor recurrence, leading to a change in treatment. Despite further interventions, the patient exhibited new-appearing symptoms and a significant increase in mass size. A 99m Tc-FAPI-46 scintigraphy showed avidity in the tumoral recurrence. This case highlights the potential of this novel, low-cost imaging technique for assessing eligibility for potential radio-ligand therapy in resource-limited countries.