68 Ga-FAPI-04: A Powerful Tool for Detecting Subcentimeter Metastases of Intrahepatic Cholangiocarcinoma

Clin Nucl Med. 2026 Feb 1;51(2):183-184. doi: 10.1097/RLU.0000000000006114. Epub 2025 Sep 18.

Abstract

A 53-year-old woman presented with subcentimeter liver metastases 18 months after resection of intrahepatic cholangiocarcinoma. 18 F-FDG PET/CT imaging demonstrated no FDG avid in the lesions, whereas 68 Ga-FAPI-04 PET identified 3 metastases with high FAPI uptake. On conventional or contrast-enhanced MRI evaluation, each sequence detected just 1-2 lesions. Our case highlights the advantage and superior sensitivity of 68 Ga-FAPI-04 over 18 F-FDG and MRI in detecting subcentimeter metastases of intrahepatic cholangiocarcinoma.

Keywords: PET/CT; PET/MRI; intrahepatic cholangiocarcinoma; subcentimeter liver metastases.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms* / diagnostic imaging
  • Bile Duct Neoplasms* / pathology
  • Cholangiocarcinoma* / diagnostic imaging
  • Cholangiocarcinoma* / pathology
  • Female
  • Gallium Radioisotopes
  • Humans
  • Liver Neoplasms* / diagnostic imaging
  • Liver Neoplasms* / secondary
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neoplasm Metastasis
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography

Substances

  • Gallium Radioisotopes