68 Ga-FAPI-04 PET/CT Demonstrates Subtype-specific Uptake Patterns in Endometriosis With Added Diagnostic Value Beyond MRI

Israel Sandler, Sandler I, Artoul F, Faozi Artoul, Anat Zick, Zick A, Inbar Ben-Shachar, Ben-Shachar I, Inbar Ben‐Shachar
Clinical nuclear medicine · 2025 · vol. 51(5) , pp. e344–e345 · doi:10.1097/rlu.0000000000006092 · PMID:40986482 · W4414451133
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

68Ga-FAPI-04 PET/CT revealed subtype-specific uptake patterns in endometriosis, including intense uptake in adenomyosis and detection of a previously unseen bowel lesion, demonstrating added diagnostic value beyond MRI.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-17 · read from full text ⓘ

This case report evaluates a 44-year-old woman with biopsy-proven endometriosis who underwent both MRI and 68Ga-FAPI-04 PET/CT imaging to assess lesion characteristics. The FAPI PET/CT revealed subtype-specific uptake patterns, showing intense signal in uterine adenomyosis, moderate uptake in deep infiltrating lesions, and mild peripheral uptake around ovarian endometriomas. Notably, the PET/CT identified an additional sigmoid-rectal junction lesion that was invisible on MRI but later confirmed surgically as bowel endometriosis. This paper is centrally about endometriosis — specifically demonstrating the complementary diagnostic value of FAPI PET/CT for detecting deep infiltrating and bowel lesions beyond standard MRI capabilities.

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Abstract

A 44-year-old woman with biopsy-proven endometriosis underwent 68 Ga-FAPI-04 PET/CT. MRI revealed bilateral ovarian endometriomas, uterine adenomyosis, and deep pelvic endometriotic lesions. FAPI PET/CT demonstrated concordant uptake in deep infiltrating lesions and intense uterine uptake corresponding to adenomyosis. Importantly, FAPI PET/CT detected an additional sigmoid-rectal junction lesion not visible on MRI, surgically confirmed as bowel endometriosis. Distinct subtype-specific uptake patterns were observed: highest in adenomyosis, high to moderate in deep infiltrating lesions, and mild peripheral uptake around ovarian endometriomas. This highlights FAPI PET/CT's complementary diagnostic value in endometriosis evaluation.
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A 44-year-old woman with biopsy-proven endometriosis underwent 68Ga-FAPI-04 PET/CT. MRI revealed bilateral ovarian endometriomas, uterine adenomyosis, and deep pelvic endometriotic lesions. FAPI PET/CT demonstrated concordant uptake in deep infiltrating lesions and intense uterine uptake corresponding to adenomyosis. Importantly, FAPI PET/CT detected an additional sigmoid-rectal junction lesion not visible on MRI, surgically confirmed as bowel endometriosis. Distinct subtype-specific uptake patterns were observed: highest in adenomyosis, high to moderate in deep infiltrating lesions, and mild peripheral uptake around ovarian endometriomas. This highlights FAPI PET/CT’s complementary diagnostic value in endometriosis evaluation. 68Ga-FAPI-04 PET/CT Demonstrates Subtype-specific Uptake Patterns in Endometriosis With Added Diagnostic Value Beyond MRI Plain Language SummaryThis case report describes a 44-year-old woman with biopsy-proven endometriosis who underwent 68Ga-FAPI-04 PET/CT alongside MRI. MRI showed bilateral ovarian endometriomas, uterine adenomyosis, and deep pelvic endometriotic lesions. FAPI PET/CT confirmed uptake in deep infiltrating lesions and showed intense uterine uptake matching adenomyosis. Crucially, FAPI PET/CT also identified a sigmoid-rectal junction lesion not seen on MRI, which was surgically confirmed as bowel endometriosis. Subtype-specific uptake patterns were noted: highest in adenomyosis, high to moderate in deep infiltrating lesions, and mild peripheral uptake around ovarian endometriomas, supporting FAPI PET/CT as a complementary tool in endometriosis evaluation. Text is machine generated and may contain inaccuracies. FAQ

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Condition tags

endometriosisadenomyosisbowel_endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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