A dual-tracer approach using [11C]CH and [18F]FDG in HCC clinical decision making

Autor: Emile B. Veenstra, Simeon J. S. Ruiter, Robbert J. de Haas, Koert P. de Jong, Paola A. Erba, Rudi A. J. O. Dierckx, Walter Noordzij
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: EJNMMI Research, Vol 13, Iss 1, Pp 1-9 (2023)
Druh dokumentu: article
ISSN: 2191-219X
DOI: 10.1186/s13550-023-01024-y
Popis: Abstract Background Early detection of recurrent or progressive HCC remains the strongest prognostic factor for survival. Dual tracer PET/CT imaging with [11C]CH and [18F]FDG can further increase detection rates as both tracers entail different metabolic pathways involved in HCC development. We investigated dual-tracer PET/CT in clinical decision making in patients suspected of recurrent or progressive HCC. All HCC patients who underwent both [11C]CH and [18F]FDG PET/CT in our institute from February 2018 to December 2021 were included. Both tracer PET/CT were within 4 weeks of each other with at least 6-month follow-up. Patients underwent dual tracer PET/CT because of unexplained and suspicious CT/MRI or sudden rise of serum tumour markers. A detected lesion was considered critical when the finding had prognostic consequences leading to treatment changes. Results Nineteen patients who underwent [11C]CH and [18F]FDG PET/CT were included of which all but six patients were previously treated for HCC. Dual-tracer critical finding detection rate was 95%, with [18F]FDG 68%, and [11C]CH 84%. Intrahepatic HCC recurrence finding rate was 65% for both tracers. [18F]FDG found more ablation site recurrences (4/5) compared to [11C]CH (2/5). Only [11C]CH found two needle tract metastases. Both tracers found 75% of the positive lymph nodes. Two new primary tumours were found, one by [18F]FDG and both by [11C]CH. Conclusions Our study favours a dual-tracer approach in HCC staging in high-risk patients or when conventional imaging is non-conclusive.
Databáze: Directory of Open Access Journals
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