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Dynamic imaging and kinetic modeling may provide additional insight, but their diagnostic value remains unclear. This study evaluated whether kinetic parameters from dynamic [\u2076\u2078Ga]Ga-FAPI-46 PET can differentiate PC from pancreatitis and their relationship with standardized uptake value (SUV) and tumor-to-blood ratio (TBR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty-one patients with suspected pancreaticobiliary cancer underwent a 45-min dynamic [\u2076\u2078Ga]Ga-FAPI-46 PET scan, followed by static scans at 60 and 180\u00a0min. Time\u2013activity curves were generated for 51 malignant and 53 benign lesions. Compartment models and Logan analysis yielded kinetic parameters (K\n                      <jats:sub>1<\/jats:sub>\n                      , k\n                      <jats:sub>2<\/jats:sub>\n                      , k\n                      <jats:sub>3<\/jats:sub>\n                      , k\n                      <jats:sub>4<\/jats:sub>\n                      , V\n                      <jats:sub>T<\/jats:sub>\n                      , V\n                      <jats:sub>NS<\/jats:sub>\n                      , V\n                      <jats:sub>S<\/jats:sub>\n                      ). SUV and TBR were correlated with V\n                      <jats:sub>T<\/jats:sub>\n                      , and group comparisons and ROC analyses assessed discriminatory performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reversible models best described the tracer kinetics. V\n                      <jats:sub>T<\/jats:sub>\n                      and V\n                      <jats:sub>S<\/jats:sub>\n                      were significantly higher in PC than pancreatitis, and k\n                      <jats:sub>2<\/jats:sub>\n                      and k\n                      <jats:sub>4<\/jats:sub>\n                      were lower, indicating higher [\u2076\u2078Ga]Ga-FAPI-46 binding respectively slower washout in malignant lesions. SUV correlated strongly with V\n                      <jats:sub>T<\/jats:sub>\n                      (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009\u2265\u20090.784)\u200b, and TBR showed very strong correlations (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009\u2265\u20090.902)\u200b for the 0\u201360\u00a0min interval, with strong correlations observed across all models and time points. ROC analyses demonstrated comparable differentiation between V\n                      <jats:sub>T<\/jats:sub>\n                      , SUV\n                      <jats:sub>max<\/jats:sub>\n                      , and TBR\n                      <jats:sub>max<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Kinetic parameters showed strong correlations with simplified methods and similar ability to differentiate PC from pancreatitis. SUV and TBR measures thus represent practical alternatives to kinetic modelling for lesion characterization.<\/jats:p>\n                    <jats:p>ClinicalTrials.gov ID: NCT05172310<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07906-2","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:15:15Z","timestamp":1778033715000},"page":"5549-5559","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Kinetic modelling of [\u2076\u2078Ga]Ga-FAPI-46 PET in pancreaticobiliary lesions: distinguishing cancer from pancreatitis"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0147-0676","authenticated-orcid":false,"given":"Ted","family":"Nilsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Rasinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Sparrelid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Tzortzakakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy A","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6rjan","family":"Smedby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimma","family":"Axelsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lubberink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Holstensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"7906_CR1","doi-asserted-by":"publisher","first-page":"7235","DOI":"10.1073\/pnas.87.18.7235","volume":"87","author":"P Garin-Chesa","year":"1990","unstructured":"Garin-Chesa P, Old LJ, Rettig WJ. 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Approval was granted by the Swedish Ethical Review Authority, and the Swedish Medical Products Agency. All participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"P.R. received a monetary scholarship from GE Healthcare Ltd. R.A. received in-kind support from SOFIE Biosciences and is also a scientific advisor for GE Healthcare Ltd. M.L. is health physics consultant for GEMS PET Systems AB (GE Healthcare). Remaining authors declare no potential conflicts of interest. The authors have no other relevant financial or non-financial interests to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Fig.\u00a01a, b and c.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}