Gallium 68-Fibroblast Activation Protein Inhibitor: PET/CT Improves Diagnosis of Neurocysticercosis

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.