Adenoid cystic carcinoma (ACC) is a rare salivary gland cancer. Still, its growth and invasion progress is slow, and its hematogenous metastasis is ACC\'s most common distant metastasis. Because of the broad expression and low background uptake of fibroblast activation protein (FAP) in tumor stroma, FAPI is considered another potential tracer of ACC in addition to FDG. In this case, we report a patient who was diagnosed with metastatic ACC liver cancer by fine needle aspiration biopsy (FNAB) and underwent PET/CT examination of [18F]FDG and [18F]FAPI-42 to find the primary cancer lesion. Finally, the primary cancer lesion was found in the left submandibular gland and was pathologically confirmed as ACC after resection.

To determine the diagnostic performance of contrast-enhanced ultrasound, diffusion-weighted magnetic resonance imaging and contrast-enhanced magnetic resonance imaging for detecting colorectal liver metastases.
We performed comprehensive searches of the MEDLINE, EMBASE, and Cochrane Library databases to identify studies reporting the per-lesion diagnostic accuracy of contrast-enhanced ultrasound, diffusion-weighted magnetic resonance imaging, and contrast-enhanced magnetic resonance imaging for detecting colorectal liver metastases. Studies published between January 2003 and December 2018 with reference standards, including histopathology and intraoperative observation, and/or follow-up, were included. Sources of bias were assessed using the QUADAS-2 tool. A linear mixed-effects regression model was used to determine sensitivity estimates.
Overall, 47 articles were included. The sensitivity estimates for contrast-enhanced ultrasound, diffusion-weighted magnetic resonance imaging, and contrast-enhanced magnetic resonance imaging for detecting colorectal liver metastases were 85.3%, 83.0%, and 90.1%, respectively. For lesions ≥10 mm in diameter, the sensitivities were 93.1%, 92.9%, and 94.5%, respectively. In 21 articles using histopathology as the only reference standard, the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for contrast-enhanced ultrasound/contrast-enhanced magnetic resonance imaging were 86%/91%, 91%/95%, 9.2/16.6, 0.15/0.10, and 61/170, respectively.
CEUS showed a diagnostic ability comparable to that of DWI and CEMRI, particularly for lesions ≥10 mm in diameter.