Journal
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Volume 38, Issue 9, Pages 1723-1731Publisher
SPRINGER
DOI: 10.1007/s00259-011-1831-z
Keywords
Nuclear hepatology; Cirrhosis; Hepatobiliary cancer; Molecular imaging; FDGal
Funding
- Danish Medical Research Council [09-061564, 09-073658]
- NIH [R01-DK074419]
- Danish Cancer Society [DP08024, DP06114]
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Purpose The aim of the study was to evaluate the feasibility of using the hepatocyte-specific positron emission tomography (PET) tracer 2-[F-18]fluoro-2-deoxy-D-galactose (FDGal) as a tracer for hepatocellular carcinoma (HCC). Methods In addition to standard clinical investigations, 39 patients with known HCC or suspected of having HCC underwent a partial-body FDGal PET/CT (from base of skull to mid-thigh). Diagnosis of HCC was based on internationally approved criteria. FDGal PET/CT images were analysed for areas with high (hot spots) or low (cold spots) tracer accumulation when compared to surrounding tissue. Results Seven patients did not have HCC and FDGal PET/CT was negative in each of them. Twenty-three patients had HCC and were included before treatment. FDGal PET/CT correctly identified 22 of these patients, which was comparable to contrast-enhanced CT. Interestingly, FDGal PET/CT was conclusive in 12 patients in whom conventional imaging techniques were inconclusive and required additional diagnostic investigations or close follow-up. Nine patients were included after treatment of HCC and in these patients FDGal PET/CT was able to distinguish between viable tumour tissue as hot spots and areas with low metabolic activity as cold spots. FDGal PET/CT detected extrahepatic disease in nine patients which was a novel finding in eight patients. Conclusion FDGal PET/CT has great clinical potential as a PET tracer for detection of extra- but also intrahepatic HCC. In the present study, the specificity of FDGal PET/CT was 100%, which is very promising but needs to be confirmed in a larger, prospective study.
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