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Purpose <p>Endometriosis can be tough to diagnose accurately, especially when standard imaging misses hidden lesions. We explored whether <sup>68</sup>Ga-FAPI-46 PET/CT, a new molecular imaging technique, could spot multifocal endometriosis that conventional methods overlook.</p> Methods <p>A 28-year-old woman with severe menstrual pain underwent transvaginal ultrasound (TVS), pelvic MRI, and <sup>68</sup>Ga-FAPI-46 PET/CT. The PET/CT scan was performed 60 minutes after injecting 3 mCi (111 MBq) of <sup>68</sup>Ga-FAPI-46, targeting fibroblast activation protein (FAP) in fibrotic tissue. We used Monte Carlo simulations (GATE v9.0) to estimate radiation doses to organs, ensuring safety.</p> Results <p>TVS and MRI detected a right ovarian endometrioma, but <sup>68</sup>Ga-FAPI-46 PET/CT went further, confirming this lesion (SUVmax 9.5) and revealing two additional nodules in the left adnexa (SUVmax 9.6) that MRI missed. Surgical pathology confirmed multifocal endometriosis. Dosimetry showed a low ovarian radiation dose (0.73 × 10<sup>− 2</sup> Gy/GBq), proving the procedure’s safety for young women.</p> Conclusion <p><sup>68</sup>Ga-FAPI-46 PET/CT is a safe and powerful tool for uncovering hidden endometriotic lesions, potentially guiding better surgical planning. While promising, larger studies are needed to confirm its role in routine practice.</p>

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68Ga-FAPI PET/CT safely detects multifocal endometriosis: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • Ghasemali Divband,
  • Arezoo Milani,
  • Masoume Chehrara,
  • Hossein Sharifi,
  • Leila Hassanzadeh

摘要

Purpose

Endometriosis can be tough to diagnose accurately, especially when standard imaging misses hidden lesions. We explored whether 68Ga-FAPI-46 PET/CT, a new molecular imaging technique, could spot multifocal endometriosis that conventional methods overlook.

Methods

A 28-year-old woman with severe menstrual pain underwent transvaginal ultrasound (TVS), pelvic MRI, and 68Ga-FAPI-46 PET/CT. The PET/CT scan was performed 60 minutes after injecting 3 mCi (111 MBq) of 68Ga-FAPI-46, targeting fibroblast activation protein (FAP) in fibrotic tissue. We used Monte Carlo simulations (GATE v9.0) to estimate radiation doses to organs, ensuring safety.

Results

TVS and MRI detected a right ovarian endometrioma, but 68Ga-FAPI-46 PET/CT went further, confirming this lesion (SUVmax 9.5) and revealing two additional nodules in the left adnexa (SUVmax 9.6) that MRI missed. Surgical pathology confirmed multifocal endometriosis. Dosimetry showed a low ovarian radiation dose (0.73 × 10− 2 Gy/GBq), proving the procedure’s safety for young women.

Conclusion

68Ga-FAPI-46 PET/CT is a safe and powerful tool for uncovering hidden endometriotic lesions, potentially guiding better surgical planning. While promising, larger studies are needed to confirm its role in routine practice.