Cancers of the oesophagogastric junction (OGJ) and proximal stomach are aggressive malignancies where accurate post-treatment assessment is critical for long-term outcomes. Conventional imaging may fail to differentiate residual disease from post-treatment changes.
⁶⁸Ga-FAPI PET-CT, a novel molecular imaging technique targeting cancer-associated fibroblasts, offers superior tumor visualization with low background uptake, making it highly effective in therapy response evaluation.
This case highlights the clinical value of ⁶⁸Ga-FAPI PET-CT in post-chemoradiation follow-up of OGJ carcinoma
Case Presentation
Patient: 35-year-old female
Diagnosis: Carcinoma of the oesophagogastric junction and proximal stomach
Referring Oncologist: Dr. Vinay Gadigi (MCh – Surgical Oncology)
Treatment History: Completed chemoradiation in November 2025
Clinical Scenario: Follow-up evaluation; baseline PET-CT not performed
Prior Imaging: CT scan dated 03/10/2025 for comparison
Imaging Technique
A whole-body ⁶⁸Ga-FAPI-04 PET-CT scan was performed using a digital time-of-flight PET-CT scanner with IV contrast. Images were acquired 30 minutes post-tracer injection, allowing high-resolution metabolic and anatomical correlation.
PET-CT Findings
The scan revealed:
Focal mild tracer uptake with minimal wall thickening along the proximal lesser curvature of the stomach (SUVmax 4.8), significantly reduced in size compared to prior CT findings
Mild tracer-avid subcentimetric lymph nodes in the porta hepatis, coeliac axis, aortocaval, and para-aortic regions—suggestive of residual nodal disease
No evidence of distant metastases to lungs, liver, bones, or brain
Clinical Impact
The scan confirmed partial metabolic response after chemoradiation
Helped distinguish residual disease from post-therapy fibrosis
Provided critical guidance for further oncologic management and surveillance
Avoided unnecessary invasive procedures due to precise molecular assessment
Why ⁶⁸Ga-FAPI PET-CT Matters
Compared to FDG PET-CT, FAPI imaging offers:
Superior lesion-to-background contrast
Minimal physiological uptake in bowel and liver
Improved detection of fibroblast-rich tumors such as gastric and OGJ cancers
This makes it an ideal modality for response assessment and restaging.
Expertise at NeuMoD Digital PET-CT, Hubli
At NeuMoD Digital PET-CT & Molecular Theranostics, Hubli, we provide:
Advanced FAPI PET-CT imaging
Prompt appointments without delays
Compassionate, patient-centric cancer care
Accurate follow-up imaging to guide precision oncology
Conclusion
This case demonstrates the pivotal role of ⁶⁸Ga-FAPI PET-CT in post-treatment evaluation of oesophagogastric junction cancer. By accurately identifying residual disease and excluding distant metastases, FAPI PET-CT enables confident clinical decision-making and personalized patient care.