Diagnostic role of radiolabelled choline PET or PET/CT in hepatocellular carcinoma: a systematic review and meta-analysis
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The role of fluorine-18-fluorodeoxygluose positron emission tomography/computed tomography (18F-FDG PET/CT) in hepatocellular carcinoma (HCC) has not been firmly established yet and its sensitivity has been reported to be in the range of 40–60 %. Because of this relatively low sensitivity alternative tracers have been proposed. The aim of our review is to analyse the literature data on the diagnostic role of 18F/11C-choline PET/CT in the evaluation of HCC. A comprehensive computer literature search of PubMed/MEDLINE, Embase and Scopus databases was conducted to find relevant published articles about the role of whole-body 18F-choline or 11C-choline PET or PET/CT in patients with HCC. Furthermore, a meta-analysis about the detection rate of this method in HCC was performed. Six articles were included in this systematic review and discussed. The meta-analysis of five out of six articles showed a DR of 84 % (95 % CI 79–89 %). The DR increased when poorly differentiated HCC was excluded from the analysis. Radiolabelled choline PET or PET/CT could be a valuable tool in detecting HCC and it is better than 18F-FDG PET/CT, especially in well to moderately differentiated lesions; on the other hand, poorly differentiated and higher-stage HCC could be better evaluated with 18F-FDG and dual tracer imaging should be considered and could be potentially useful to increase accuracy.
Keywords18F-choline 11C-choline HCC Hepatocellular carcinoma PET/CT
Compliance with ethical requirements and Conflict of interest
All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration. Francesco Bertagna, Mattia Bertoli, Giovanni Bosio, Giorgio Biasiotto, Ramin Sadeghi, Raffaele Giubbini and Giorgio Treglia declare that they have no conflict of interest.
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