Hepatic Metastasis From Duodenal Ampullary Carcinoma With Intense FAP Activity But Without FDG Uptake.

Duan, Runze; Cai, Xiaoyu; Zheng, Lu; Bian, Yanzhu; Hu, Yujing · Clin Nucl Med · 2026

prospective_cohort · Level II

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Abstract

A 58-year-old man with 3 years postduodenal ampullary carcinoma surgery underwent a routine abdominal CT 1 week ago, revealing occupancy of the S7 segment of the liver, suggesting a probability of metastasis. Serum CA19-9 and CEA levels were within the reference range. The patient, with informed consent, was then enrolled in a clinical trial of comparison of 18 F-FDG and 68 Ga-FAPI-04 PET/CT in hepatic lesions. Compared with the absence of tracer uptake on 18 F-FDG PET/CT, 18 Ga-FAPI-04 PET/CT showed high tracer uptake and prominent tumor-to-background contrast. The final pathology confirmed an infiltrating adenocarcinoma, originating from the primary duodenal ampullary carcinoma.

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