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PET/CT in patients with hepatocellular carcinoma using [18F]fluorocholine: preliminary comparison with [18F]FDG PET/CT

European Journal of Nuclear Medicine and Molecular Imaging volume 33, pages 1285–1289 (2006)Cite this article

Abstract

Purpose

The diagnostic accuracy of [18F]fluorodeoxyglucose (FDG) PET is insufficient to characterise hepatocellular carcinoma (HCC) in liver masses and to diagnose all cases of recurrent HCC. HCC has been reported to take up [11C]acetate, but routine use of this tracer is difficult. Choline is another tracer of lipid metabolism, present in large amounts in HCC. In a proof-of-concept study, we evaluated [18F]fluorocholine (FCH) uptake by HCC and compared FCH PET/CT with FDG PET/CT.

Methods

Twelve patients with newly diagnosed (n=8) or recurrent HCC (n=4) were prospectively enrolled. HCC was assessed by histology in eight cases and by American Association for the Study of Liver Diseases (AASLD) criteria in four cases. All patients underwent whole-body PET/CT 10 min after injection of 4 MBq/kg FCH. Within 1 week, 9 of the 12 patients also underwent whole-body FDG PET/CT 1 h after injection of 5 MBq/kg FDG.

Results

The per-patient analysis showed a detection rate of 12/12 using FCH PET/CT for both newly diagnosed and recurrent HCC. The median signal to noise ratio was 1.5±0.38. There was a trend towards a higher FCH SUVmax in well-differentiated HCC (15.6±7.9 vs 11.9±0.9, NS). Of the nine patients who underwent FCH and FDG PET/CT, all nine were positive with FCH whereas only five were positive with FDG.

Conclusion

FCH provides a high detection rate for HCC, making it potentially useful in the initial evaluation of HCC or in the detection of recurrent disease. The favourable result of this proof-of-concept study opens the way to a phase III prospective study.

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Affiliations

  1. Department of Nuclear Medicine, Hôpital Tenon, AP-HP, et Université Pierre et Marie Curie, Paris, France

    Jean-Noël Talbot, Fabrice Gutman, Khaldoun Kerrou, Dany Grahek & Françoise Montravers

  2. Department of Hepatology, Hôpital Saint-Antoine, AP-HP, et Université Pierre et Marie Curie, Paris, France

    Laetitia Fartoux, Raoul Poupon & Olivier Rosmorduc

  3. Department of Hepatology, Hôpital Tenon, AP-HP, et Université Pierre et Marie Curie, Paris, France

    Jean-Didier Grange

  4. Department of Hepatology, Hôpital Jean Verdier, AP-HP, Bondy, France

    Nathalie Ganne

Authors
  1. Jean-Noël Talbot
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  2. Fabrice Gutman
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  3. Laetitia Fartoux
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  4. Jean-Didier Grange
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  5. Nathalie Ganne
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  6. Khaldoun Kerrou
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  7. Dany Grahek
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  8. Françoise Montravers
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  9. Raoul Poupon
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  10. Olivier Rosmorduc
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Correspondence to Fabrice Gutman.

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Talbot, JN., Gutman, F., Fartoux, L. et al. PET/CT in patients with hepatocellular carcinoma using [18F]fluorocholine: preliminary comparison with [18F]FDG PET/CT. Eur J Nucl Med Mol Imaging 33, 1285–1289 (2006). https://doi.org/10.1007/s00259-006-0164-9

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  • DOI: https://doi.org/10.1007/s00259-006-0164-9

Keywords

  • Hepatology
  • PET
  • Oncology
  • Fluorocholine-(18F)
  • PET/CT