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

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.