Fig. 6.

Eight patients with pancreatic cancer underwent ¹⁸F-FDG and ⁶⁸ Ga-FAPI-04 PET/CT imaging. ⁶⁸ Ga-FAPI-04 PET/CT outperformed ¹⁸F-FDG in detecting primary tumors (solid arrows), supraclavicular lymph node metastases (arrowhead), abdomen lymph node metastases, liver metastases, peritoneal carcinomatosis, and bone metastases (dotted arrows) (a). The patient with pancreatic cancer was visible the high metabolic activity of the primary tumor on the ¹⁸F-FDG PET/CT and ⁶⁸ Ga-FAPI-04 PET/CT scan (solid arrows). However, the 1-h image for ⁶⁸ Ga-FAPI-04 PET/CT (middle line) demonstrated intense ⁶⁸ Ga-FAPI-04 uptake in the body and tail of the pancreas (white and black dotted arrows) and moderate FAPI uptake in the intrahepatic bile duct (red dotted arrows). 3-h delayed ⁶⁸ Ga-FAPI-04 PET was performed to differentiate between malignant and benign lesions (right line). The SUVmax value of the primary tumor was slightly elevated, whereas the SUVmax values of the pancreatitis lesions were decreased compared to the 1-h standard image (b). A 53-year-old man suffered from retrosternal and laryngeal discomfort for more than 9 months. Laboratory testing revealed a high CEA level (11.3 μg/L). ⁶⁸ Ga-FAPI-04 PET/MR revealed focal uptake in the pancreatic neck with a negative corresponding MR signal. Furthermore, no abnormal lesions were found in subsequent DCE-MRI and EUS (c). Figure adapted from Pang et al. [71] and Zhang et al. [72]