PDF(Pubmed)
Abstract：
Fibroblast Activation Protein Inhibitor (FAPI) positron emission tomography (PET) imaging has emerged as a useful method for identifying pancreatic disorders, notably pancreatitis. Unlike Fluorine-18 fluorodeoxyglucose (FDG), FAPI uptake is directly proportional to the degree of fibrosis, making it very useful in separating pancreatic tumors from inflammation. Recent investigations have shown that FAPI positron emission tomography/computer tomography (PET/CT) can identify pancreatic inflammation with great sensitivity, providing vital diagnostic information. In this case study, a 52-year-old male with a history of Ewing sarcoma presented with epigastric pain. Pancreatitis was confirmed on a computer tomography (CT) scan showing mild fat stranding in the pancreatic body and tail, in addition to a significant increase in pancreatic head mass, necessitating further evaluation with FDG PET/CT and FAPI PET/CT, as the patient was known to have metastatic sarcoma. While FDG PET/CT revealed an avid infiltrative lesion in the duodenal/pancreatic head area, FAPI PET/CT showed diffuse uptake in the pancreatic body and tail, indicating fibroblast-mediated inflammation consistent with pancreatitis. This case demonstrates the usefulness of FAPI imaging in discriminating between pancreatic metastasis and pancreatitis, with FAPI PET/CT providing crucial diagnostic information when FDG uptake is ambiguous.
摘要：
成纤维细胞激活蛋白抑制剂（FAPI）正电子发射断层扫描（PET）成像已成为识别胰腺疾病的有用方法，尤其是胰腺炎。与氟-18氟脱氧葡萄糖（FDG）不同，FAPI摄取与纤维化程度成正比，使其在分离胰腺肿瘤和炎症中非常有用。最近的研究表明，FAPI正电子发射断层扫描/计算机断层扫描（PET/CT）可以非常敏感地识别胰腺炎症，提供重要的诊断信息。在这个案例研究中,一名52岁男性，有尤因肉瘤病史，表现为上腹痛。在计算机断层扫描（CT）扫描中证实了胰腺炎，显示胰腺体和尾部有轻度脂肪滞留，除了胰头质量显著增加，需要使用FDGPET/CT和FAPIPET/CT进行进一步评估，因为已知患者患有转移性肉瘤。虽然FDGPET/CT显示十二指肠/胰头区有强烈的浸润性病变，FAPIPET/CT显示胰体尾弥漫性摄取,提示成纤维细胞介导的炎症与胰腺炎一致。此病例证明了FAPI成像在区分胰腺转移和胰腺炎中的有用性。当FDG摄取不明确时，FAPIPET/CT可提供关键的诊断信息。
