Multiple Intrahepatic Inflammatory Myofibroblastic Tumor on 68Ga-FAPI and 18F-FDG PET/CT

Abstract

A 31-year-old man with multiple intrahepatic inflammatory myofibroblastoma tumor was referred to nuclear medicine department to assess its malignant potential. Multiple lesions in the liver exhibited 68Ga-FAPI uptake at different degrees. Instead, there was no abnormal 18F-FDG activity in the other hepatic lesions under the normal liver background except for the puncture site. This case reflects tumor heterogeneity of the disease and shows the potential value of 68Ga-FAPI PET/CT for the evaluation of hepatic inflammatory myofibroblastoma tumor.

Intense 18F-FAPI Uptake in Small Recurrent Lesions of Combined Hepatocellular-Cholangiocarcinoma Negative on 18F-FDG PET/CT

“…Several studies have demonstrated that 68 Ga/ 18 F-FAPI PET/CT is more effective than 18 F-FDG PET/CT in detecting primary and recurrent liver cancers, including hepatocellular carcinoma, 4-6 intrahepatic cholangiocarcinoma, 5,6 mucosa-associated lymphoid tissue, 7 liver metastases, 8,9 and some benign liver diseases. 6,[10][11][12] In our case, significant 18 F-FAPI uptake was observed, suggesting that 18…”

“…But in our case, the small recurrent cHCC-CC lesion demonstrated a low level of 18 F-FDG uptake, leading to a false-negative 18 F-FDG PET/CT result. Several studies have demonstrated that 68 Ga/ 18 F-FAPI PET/CT is more effective than 18 F-FDG PET/CT in detecting primary and recurrent liver cancers, including hepatocellular carcinoma, 4–6 intrahepatic cholangiocarcinoma, 5,6 mucosa-associated lymphoid tissue, 7 liver metastases, 8,9 and some benign liver diseases 6,10–12 . In our case, significant 18 F-FAPI uptake was observed, suggesting that 18 F-FAPI PET/CT may be a promising imaging procedure in the management of cHCC-CC.…”