Gallium 68-Fibroblast Activation Protein Inhibitor: PET/CT Improves Diagnosis of Neurocysticercosis
Priyankkumar G. Moradiya
Department of Radio-Diagnosis, Bharati Vidyapeeth Medical College, Pune, India.
Rahul S. Mahajan
Moraya Multispeciality Charitable Hospital, Pune, India.
Shrikant V. Solav
*
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
Shailendra V. Savale
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
Gauri S. Khajindar
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
Rajlaxmi R. Jagtap
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
Aman S. Solav
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
Suresh L. Balani
Department of Nuclear Medicine, SPECTLAB Nuclear Medicine Services, Pune, India.
*Author to whom correspondence should be addressed.
Abstract
F18-FDG (Fluorine18- fluoro-deoxyglucose) Positron emission tomography/computerized tomography scan (PET/CT Scan) scan shows intense physiologic uptake in the brain parenchyma. This prevents evaluation of small cerebral lesions. Ga-68-FAPI (Gallium68- Fibroblast activation protein inhibitor) does not localize in normal brain parenchyma. Hence, it can detect cerebral lesions which concentrate the tracer. We report a case of neurocysticercosis in a 32 years old female who presented with headache, nausea and one episode of seizure. MRI brain raised possibility of tuberculoma over neurocysticercosis. There was a hypometabolic area in the right temporal lobe as revealed by F-18-FDG PET/CT, with no FDG avid lesions or lymph nodes identified in the body. Ga68-FAPI PET/CT was performed which showed increased tracer uptake within the right temporal lobe lesion. A focal FAPI uptake was also noted in a tiny hypodense lesion in the left internal oblique muscle of abdomen, which showed signal characteristics of intramuscular cysticercosis on limited MRI study.
Keywords: Cysticercosis, MR imaging, in cancer imaging, neurology