Deficiency of 68Ga-FAPI-04 PET/CT Compared With 18F-FDG PET/CT in Staging Metastatic Paraganglioma: A Case Report.

A 26-year-old man was incidentally found to have a retroperitoneal mass. 18F-FDG PET/CT showed intense uptake in the retroperitoneal mass, lymph nodes, and bone lesions. Contrast-enhanced MRI revealed significant and similar enhancement in the retroperitoneal mass, lymph nodes, and the lesion in the L5 vertebral body, supporting the diagnosis of metastases. In contrast, 68Ga-FAPI-04 PET/CT demonstrated intense uptake in the retroperitoneal mass, but only mild uptake in the L5 vertebral body and negligible uptake in other lesions. Histopathological examination confirmed paraganglioma. This case suggests that 68Ga-FAPI-04 PET/CT may be less effective than 18F-FDG PET/CT for staging metastatic paraganglioma.