Chuanyin Sun,1,* Haopeng Ni,2,* Mengdi Jiang,1 Guolin Wang,3 Xinhui Su,3 Zhenfeng Liu3 

1Department of Rheumatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People’s Republic of China; 2Zhejiang University School of Medicine, Hangzhou, Zhejiang, 3100058, People’s Republic of China; 3Department of Nuclear Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zhenfeng Liu; Xinhui Su, Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People’s Republic of China, Email zhenfeng19792003@zju.edu.cn; suxinhui@zju.edu.cn

Abstract: Kimura’s disease is a rare, chronic inflammatory disorder characterized by subcutaneous nodules, eosinophilia, and elevated serum IgE levels. It commonly affects young Asian males and typically presents in the head and neck region. Diagnosis is confirmed via histopathological examination, while treatment options include corticosteroids, surgery, and radiotherapy. [18F]AlF-NOTA-FAPI-04 PET/CT demonstrated superior imaging, with clearer background and higher target-to-background ratio, highlighting lesions with higher SUV values and greater specificity for fibroblast activity. Compared to 18F-FDG PET/CT, which is limited by nonspecific uptake in inflammatory tissues, [18F]AlF-NOTA-FAPI-04 PET/CT offers superior sensitivity and specificity in visualizing fibroblast activation. These advantages not only improve diagnostic accuracy in Kimura’s disease but may also have broader implications for other eosinophilic or inflammatory disorders sharing similar clinical features. This technique improves diagnostic accuracy, facilitates treatment planning, and may guide the development of future treatment.

Keywords: kimura’s disease, FAPI, PET