This lecture presents a case of a 54-year-old female with biopsy-proven pancreatic ductal adenocarcinoma, referred for FAPI PET/CT as part of initial staging. The study highlights the role of FAPI imaging in characterizing the primary tumor, assessing vascular involvement, and detecting nodal and hepatic metastases.

By integrating morphologic and functional findings, this case demonstrates how FAPI PET/CT can contribute to staging and treatment planning in pancreatic malignancy.

Learning Objectives

By the end of this lecture, participants will be able to:

• Identify the imaging features of pancreatic ductal adenocarcinoma on FAPI PET/CT.
• Assess tumor extent, including peripancreatic fat infiltration and ductal obstruction.
• Evaluate vascular involvement, particularly the portal–splenic–SMV confluence, and understand when contrast-enhanced CT is required.
• Detect nodal and hepatic metastases using FAPI PET/CT.
• Appreciate the role of FAPI imaging in staging and treatment planning for pancreatic cancer.