The role of ⁶⁸ Ga-FAPI PET/CT in differentiating nasopharyngeal mucosal inflammation from nasopharyngeal carcinoma

Radiologists are sometimes faced with a dilemma in differentiating inflammatory mucosal thickening from malignant disease. In this case, we reported 18 F-fluorodeoxyglucose (FDG) and 68 Ga-fibroblast activation protein inhibitor (FAPI) PET/CT findings in a 48-year-old patient with suspected nasopharyngeal carcinoma. 18 F-FDG PET/CT showed diffuse soft-tissue thickening with intense radiotracer uptake in the nasopharynx. However, no abnormal 68 Ga-FAPI uptake was observed in the nasopharyngeal mass. The pathological examinations after endoscopic excision confirmed the diagnosis of inflammatory mucosal thickening of the nasopharynx. This case demonstrates that 68 Ga-FAPI PET/CT may be more specific than 18 F-FDG PET/CT and MRI in differentiating nasopharyngeal mucosal inflammation from nasopharyngeal carcinoma.