Aspergillus fumigatus: Is Dual-Tracer 18 FDG/ 68 Ga-FAPI PET/CT Capable of Distinguishing Fungal Infection and Unspecific Inflammation From Recurrent Lung Cancer?

Clin Nucl Med. 2024 Nov 1;49(11):1046-1047. doi: 10.1097/RLU.0000000000005393. Epub 2024 Jul 31.

Abstract

A 61-year-old woman, referred for recurrent pneumonia over a period of 3 months with insufficient response to antibiotic treatment, presented with coughing and intense right-sided chest pain. Previously, she underwent right upper lobectomy for locally advanced non-small cell lung cancer (squamous cell carcinoma) followed by adjuvant chemotherapy and subsequent partial chest wall resection with polytetrafluoroethylene net insert due to a pleurocutaneous fistula. 18 FDG plus a 68 Ga-labeled fibroblast activation protein inhibitor ( 68 Ga-FAPI) PET/CT scans were performed to rule out non-small cell lung cancer recurrence. Pathological workup with bronchoscopy and endobronchial ultrasound-guided transbronchial fine-needle aspiration of the lymph nodes showed no evidence of malignancy, but microbiology confirmed Aspergillus fumigatus infection of the middle lobe. Thus, the patient transitioned from antibiotic to antifungal therapy; no second-line oncologic treatment was initiated.

Publication types

  • Case Reports

MeSH terms

  • Aspergillosis / diagnostic imaging
  • Aspergillus fumigatus*
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Gallium Radioisotopes
  • Humans
  • Inflammation / diagnostic imaging
  • Lung Neoplasms* / diagnostic imaging
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Positron Emission Tomography Computed Tomography*
  • Recurrence

Substances

  • Fluorodeoxyglucose F18
  • Gallium Radioisotopes