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Mol Imaging Radionucl Ther. 2012 Apr;21(1):6-12. doi: 10.4274/Mirt.87. Epub 2012 Apr 1.

Adding 11C-acetate to 18F-FDG at PET Examination Has an Incremental Value in the Diagnosis of Hepatocellular Carcinoma.

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  • 1Karolinska University Hospital Solna, Departments of Radiology and Nuclear Medicine, Solna, Sweden.

Abstract

OBJECTIVE:

The sensitivity of FDG at PET examination of Hepatocellular Carcinoma (HCC) is restricted. In a few studies, all done in Oriental patients, PET-examination with (11)C-acetate has shown a higher accuracy than with FDG. In the current study, the uptake of (11)C-acetate has been compared with the uptake of FDG in the primary HCC in a cohort of Occidental patients.

MATERIAL AND METHODS:

44 patients underwent PET-examination with both tracers with a mean of 9 days between the examinations. 26 patients had a microscopical diagnosis and 18 were diagnosed with multimodal radiological methods. At least one relevant radiological examination was available for comparison.

RESULTS:

At visual evaluation, 13 of the HCC's were positive at PET-examination using FDG and 34 were positive using (11)C-acetate (p<0.001). Median tumor SUVmean of (11)C-acetate was 4.7 and of FDG was 1.9 (p<0.001). There was also a higher uptake of (11)C-acetate by the surrounding liver tissue than of FDG. Median liver SUVmean of [u]11[/u]C-acetate was 3.2 and of FDG it was 1.7 (p<0.001). This corresponded to a median tumour/liver tissue ratio for (11)C-acetate of 1.4 and for FDG of 1.0 (p<0.05). Previous reports of a negative correlation between the uptake of the tracers were weakly supported. In 4 large tumors some portions being hot using one of the tracers were cold using the other tracer and vice versa.

CONCLUSION:

Adding registration with (11)C-acetate to registration with FDG at PET-examination has an incremental value in the diagnosis of HCC. A higher tumor uptake of (11)C-acetate cannot be taken full advantage of because of a higher uptake also by the surrounding liver tissue.

CONFLICT OF INTEREST:

None declared.

KEYWORDS:

(11C)-acetate; 18F-FDG; Hepatocellular carcinoma; positron-emission; sensitivity; tomography

PMID:
23487415
[PubMed]
PMCID:
PMC3590959
Free PMC Article
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