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KMID : 1148920210550050257
Nuclear Medicine and Molecular Imaging
2021 Volume.55 No. 5 p.257 ~ p.260
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 Dheeratama

Promteangtrong Chetsadaporn
Kunawudhi Anchisa
Kiatkittikul Peerapon
Chotipanich Chanisa
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. 68 Ga-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
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