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Post-pancreatic surgery, differentiation of postoperative reactive tissue (PRT) and PDAC-recurrence challenges oncological imaging. Static\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-PET\/CT uptake is increased in all of these lesions with marked overlap in signal intensity, hampering their FAPI-PET-based assessment. Here, we evaluated static and parametric imaging parameters for discrimination of pancreatic lesions in primary and post-pancreatic surgery scenarios.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      55 Patients with pancreatic lesions (36 primary, 19 post-pancreatic surgery) underwent static and dynamic\n                      <jats:sup>68<\/jats:sup>\n                      Ga-FAPI-46-PET\/CT. Primary lesions were classified either by histology following PET\/CT or follow-up (&gt;\u20096 months). Post-surgery, PRT and PDAC-recurrence were classified by CT- and clinical course (&gt;\u200918 months). Parametric maps (1 tissue compartment (1TC), 2TC and Logan plot (LP)) from dynamic PET-data were generated via image-based aortic input function using PMOD-software. Pancreatic lesions (PDAC, ILP, PRT, PDAC-recurrence) were then delineated using VOI-technique (30\u201370% isocontour) and signal intensities were analyzed. SPSS was used to detect outliers, unpaired t-tests was applied for comparison of static and parametric imaging parameters. Receiver-operating-characteristic curves for differentiating PDAC\/ILP or recurrent PDAC\/PRT were generated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>42 patients were included in the final analysis: in primary setting, 16 PDAC and 10 ILP; in post-surgery setting 9 PDAC-recurrences and 7 PRT. In the primary setting, although PDAC showed higher SUVmax\/mean than ILP, no significant differences in maximum\/mean signal values neither in static imaging nor in parametric maps were detected. With regard to the differentiation of PDAC-recurrences versus postoperative tissue, LPmax were significantly higher in PDAC-recurrences compared to PRT (4.74 vs. 2.40, p-value 0.020) with AUC 82.5% (95-CI 0.62-1.0) and a possible diagnostic threshold at &gt;\u20093,49 (LR\u2009+\u20095.44), while differences in static imaging or other parametric maps were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Differentiating pancreatic lesions remains challenging. While LPmax significantly distinguished PDAC-recurrence from PRT, other parametric mapping parameters yielded no significant results. Larger studies and additional dynamic data analysis methods should be explored.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40644-026-01040-w","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:27:01Z","timestamp":1777375621000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parametric mapping of dynamic 68Ga FAPI-46-PET data of 42 patients with pancreatic lesions"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1092-5773","authenticated-orcid":false,"given":"Anna-Maria","family":"Spektor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"von Goetze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Georg","family":"Buchholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Heger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Liermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Knoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Herfarth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Schreckenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Haberkorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-243X","authenticated-orcid":false,"given":"Manuel","family":"R\u00f6hrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"10242","key":"1040_CR1","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1016\/S0140-6736(20)30974-0","volume":"395","author":"JD Mizrahi","year":"2020","unstructured":"Mizrahi JD, et al. 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