Nucl Med Mol Imaging.  2021 Oct;55(5):257-260. 10.1007/s13139-021-00712-8.

⁶⁸Ga-FAPI-46 PET/MR Detects Recurrent Cholangiocarcinoma and Intraductal Papillary Mucinous Neoplasm in a Patient Showing Increasing CEA with Negative ¹⁸F-FDG PET/CT and Conventional CT

• Siripongsatian D
• Promteangtrong C
• Kunawudhi A
• Kiatkittikul P
• Chotipanich C

• KMID: 2521464
• DOI: http://doi.org/10.1007/s13139-021-00712-8

Abstract

A patient with intrahepatic cholangiocarcinoma who underwent hepatic resection with completed neoadjuvant chemotherapy presented with increased CEA levels. Previous whole abdominal and chest CT scan revealed no evidence of local recurrence or metastasis. ⁶⁸Ga-FAPI-46 PET showed significantly higher tumor-to-background contrast of recurrent tumor and nodal metastasis, which were undetectable in the FDG PET or conventional CT scan. These findings changed patient management. Larger studies with histopathological correlation and comparisons with other imaging modalities are required to validate the diagnostic performance. Moreover, a cystic lesion with FAPI uptake at the neck to the proximal body of the pancreas without FDG uptake is also incidentally noted. Differential diagnoses include sided branch IPMN and serous cystadenoma.

Keyword

Cholangiocarcinoma; Intraductal papillary mucinous neoplasm (IPMN); Fibroblast activation protein; FDG; PET/CT; PET/MRI