Abstract
BACKGROUND: The coexistence of lung cancer and pulmonary tuberculosis (TB) makes differential diagnosis even more complicated. The purpose of the study is to explore superiority of [(18)F]-NOTA-FAPI-04 PET/CT in distinguishing TB from malignant lesions and accurately detecting inflammatory lymph nodes than [(18)F]-FDG PET/CT. CASE SUMMARY: Herein, we described a case report of a patient with both lung cancer and tuberculosis underwent [(18)F]-FDG and Al[(18)F]-NOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) to determine staging. Additionally, a literature review was conducted to discuss the potential clinical applications of FAPI PET/CT. We reported a 70-year-old man with newly diagnosed lung squamous cell carcinoma underwent [(18)F]-FDG and Al[(18)F]-NOTA-FAPI-04 PET/CT to determine staging. The avid uptake of [(18)F]-FDG in old pulmonary TB and the right hilar inflammatory lymph nodes (<1 cm) were not found on Al [(18)F]-NOTA-FAPI-04 PET/CT. After 2 months of follow-up, the small lymph node was finally confirmed to be inflammatory. CONCLUSION: Al[(18)F]-NOTA-FAPI-04 PET/CT may perform better in distinguishing TB from malignancy and may offer greater specificity than [(18)F]-FDG PET/CT for the diagnosis inflammatory lymph nodes.