Targeting Imaging Modality in the Diagnosis of Endometriosis: 68Ga-FAPI-04 PET/CT

Hatice Uslu, Hamza A Kösem, Meryem Hocaoğlu, Burak Canitez, Dilruba Şahin
In: Clinical Nuclear Medicine · 2026 · doi:10.1097/rlu.0000000000006622 · W7204186793
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This study evaluated 68Ga-FAPI-04 PET/CT for diagnosing endometriosis in eight women, demonstrating that targeting fibroblast activation protein offers high accuracy compared to other imaging methods.

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This case series evaluated the diagnostic utility of 68Ga-FAPI-04 PET/CT in eight women with histopathologically confirmed endometriosis presenting with cyclic pelvic or extrapelvic pain. The researchers focused on fibroblast activation protein as a molecular target due to its strong expression in the perilesional stroma of endometriotic lesions, aiming to address the significant delays often caused by nonspecific symptoms and limited standard imaging. The results demonstrated that FAPI PET/CT achieved high accuracy in detecting endometriotic foci compared to other conventional imaging modalities in this small cohort. This paper is centrally about endometriosis — specifically evaluating a novel PET imaging agent for diagnosing deep infiltrating and nodular disease.

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Abstract

Endometriosis is a chronic condition in reproductive-age women, and diagnosis can be delayed for 4–11 years due to nonspecific symptoms and limited imaging. This underscores the need for new methods to overcome these diagnostic challenges. Fibroblast activation protein, strongly expressed in the perilesional stroma of endometriotic lesions, is a promising PET target. We included 8 women who underwent 68 Ga-FAPI-04 PET/CT for cyclic pelvic or extrapelvic pain and solid nodular lesions, later histopathologically confirmed as endometriosis. In these patients, we showed the targeting diagnostic potential of FAPI PET/CT and endometriotic foci with high accuracy compared with other imaging methods.
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Interesting Image Targeting Imaging Modality in the Diagnosis of Endometriosis: 68 Ga-FAPI-04 PET/CT - Hatice Uslu - Hamza A. Kösem - Meryem Hocaoglu - Burak Canıtez - Dilruba Şahin Clinical Nuclear Medicine Publish Ahead of Print, August 24, 2026. | DOI: 10.1097/RLU.0000000000006622 Endometriosis is a chronic condition in reproductive-age women, and diagnosis can be delayed for 4–11 years due to nonspecific symptoms and limited imaging. This underscores the need for new methods to overcome these diagnostic challenges. Fibroblast activation protein, strongly expressed in the perilesional stroma of endometriotic lesions, is a promising PET target. We included 8 women who underwent 68Ga-FAPI-04 PET/CT for cyclic pelvic or extrapelvic pain and solid nodular lesions, later histopathologically confirmed as endometriosis. In these patients, we showed the targeting diagnostic potential of FAPI PET/CT and endometriotic foci with high accuracy compared with other imaging methods. Endometriosis is a chronic condition in reproductive-age women, and diagnosis can be delayed for 4–11 years because symptoms are nonspecific and standard imaging is limited. Fibroblast activation protein, which is strongly expressed in the perilesional stroma of endometriotic lesions, is a promising PET target. This study included 8 women who underwent 68Ga-FAPI-04 PET/CT for cyclic pelvic or extrapelvic pain and solid nodular lesions that were later histopathologically confirmed as endometriosis. In these patients, FAPI PET/CT showed high diagnostic accuracy for detecting endometriotic foci compared with other imaging methods, suggesting this technique may help overcome current diagnostic challenges in endometriosis. Text is machine generated and may contain inaccuracies. FAQ Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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