Superiority of 18F-FAPI PET/CT to 18F-FDG PET/CT in the Evaluation of Synchronous Renal and Uterine PEComa

A 24-year-old woman presented with abdominal distension for 1 week. Abdominal contrast-enhanced CT showed 2 abnormal enhanced lesions in uterine fundus and in the lower pole of the right kidney, suggesting a probability of malignancies. As part of a clinical trial, the patient underwent both ¹⁸ F-FAPI and ¹⁸ F-FDG PET/CT to assess the malignancy of the lesions. Compared with ¹⁸ F-FDG PET/CT, ¹⁸ F-FAPI PET/CT demonstrated more intense and extensive tracer uptake in these lesions. Finally, pathologic analysis confirmed perivascular epithelioid cell tumors.