A Prospective Evaluation of18F-FDG and11C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma
| Autor: | Woojin Lee, Chang-Min Kim, Keon Wook Kang, Ji Hoon Kim, Joong-Won Park, Seok Ki Kim, Byung-Ho Nam, Kyung Woo Park, Jun Il Choi |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Acetates Risk Assessment Sensitivity and Specificity Fluorodeoxyglucose F18 Risk Factors Internal medicine medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study neoplasms Survival rate Survival analysis PET-CT Korea business.industry Incidence Liver Neoplasms Reproducibility of Results Middle Aged Hepatology Prognosis medicine.disease Survival Analysis Thrombosis Carbon Survival Rate Positron-Emission Tomography Subtraction Technique Hepatocellular carcinoma Female Radiology Radiopharmaceuticals Tomography X-Ray Computed business Nuclear medicine |
| Zdroj: | Journal of Nuclear Medicine. 49:1912-1921 |
| ISSN: | 2159-662X 0161-5505 |
| DOI: | 10.2967/jnumed.108.055087 |
| Popis: | Because (18)F-FDG PET has insufficient sensitivity for the detection of hepatocellular carcinoma (HCC), (11)C-acetate PET has been proposed as another technique for this use. We prospectively evaluated the value of PET/CT using these 2 tracers for the detection of primary and metastatic HCC.One hundred twelve patients (99 with HCC, 13 with cholangiocellular carcinoma) underwent biopsy and (18)F-FDG and (11)C-acetate PET/CT.The overall sensitivities of (18)F-FDG, (11)C-acetate, and dual-tracer PET/CT in the detection of 110 lesions in 90 patients with primary HCC were 60.9%, 75.4%, and 82.7%, respectively. Elevated serum alpha-fetoprotein levels, an advanced tumor stage, portal vein tumor thrombosis, large tumors, and multiple tumors were significantly associated with positive (18)F-FDG PET/CT results. Uptake of (11)C-acetate was associated with large and multiple tumors. For (18)F-FDG, the sensitivities according to tumor size (1-2, 2-5, and/=5 cm) were 27.2%, 47.8%, and 92.8%, respectively; for (11)C-acetate, these respective values were 31.8%, 78.2%, and 95.2%. (18)F-FDG was more sensitive in the detection of poorly differentiated HCC. Overall survival was lower in patients with (18)F-FDG PET/CT positive for all indexed lesions than in those with FDG negative or partially positive through the entire follow-up period. In analysis based on biopsied lesions, the sensitivity of (18)F-FDG PET/CT was 64.4% for primary HCC and 84.4% for (11)C-acetate PET/CT. The overall sensitivities of (18)F-FDG, (11)C-acetate, and dual-tracer PET/CT for 35 metastatic HCCs were 85.7%, 77.0%, and 85.7%, respectively. There was no significant difference in the sensitivity of tracers according to metastatic tumor size, location, or differentiation.The addition of (11)C-acetate to (18)F-FDG PET/CT increases the overall sensitivity for the detection of primary HCC but not for the detection of extrahepatic metastases. (18)F-FDG, (11)C-acetate, and dual-tracer PET/CT have a low sensitivity for the detection of small primary HCC, but (18)F-FDG PET/CT has a relatively high sensitivity for the detection of extrahepatic metastases of HCC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|