Diagnostic Superiority of 68Ga-FAPI PET/CT Over 18F-FDG in Restaging of Advanced Epithelioid Sarcoma
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.
Authors
- Emran Askari (ORCID: https://orcid.org/0000-0002-2973-2251)
- Alireza Bari (ORCID: https://orcid.org/0000-0002-0299-8316)
- Amin Saber Tanha (ORCID: https://orcid.org/0009-0008-0290-0412)
- Faeze Rabani
- Haniye Elahifard
Institutions
- Mashhad University of Medical Sciences (IR)
- Tehran University of Medical Sciences (IR)
Publication Details
- Journal
- Clinical Nuclear Medicine
- Published
- 2026-09-08
- DOI
- https://doi.org/10.1097/rlu.0000000000006685
- Primary Topic
- Peptidase Inhibition and Analysis
- Type
- article
- Field-Weighted Citation Impact
- 0.00