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Diagnostic value of combining 11C-choline and 18F-FDG PET/CT in hepatocellular carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

In this prospective study, our goal was to emphasize the diagnostic value of combining 11C-choline and 18F-FDG PET/CT for hepatocellular carcinoma (HCC) in patients with chronic liver disease.

Methods

Thirty-three consecutive patients were enrolled. All patients were suspected to have HCC based on CT and/or MRI imaging. A final diagnosis was obtained by histopathological examination or by imaging alone according to American Association for the Study of Liver Disease criteria. All patients underwent PET/CT with both tracers within a median of 5 days. All lesions showing higher tracer uptake than normal liver were considered positive for HCC. We examined how tracer uptake was related to biological (serum α-fetoprotein levels) and pathological (differentiation status, peritumoral capsule and vascular invasion) prognostic markers of HCC, as well as clinical observations at 6 months (recurrence and death).

Results

Twenty-eight HCC, four cholangiocarcinomas and one adenoma were diagnosed. In the HCC patients, the sensitivity of 11C-choline, 18F-FDG and combined 11C-choline and 18F-FDG PET/CT for the detection of HCC was 75 %, 36 % and 93 %, respectively. Serum α-fetoprotein levels >200 ng/ml were more frequent among patients with 18F-FDG-positive lesions than those with 18F-FDG-negative lesions (p < 0.05). Early recurrence (n=2) or early death (n=5) occurred more frequently in patients with 18F-FDG-positive lesions than in those with 18F-FDG-negative lesions (p < 0.05).

Conclusion

The combined use of 11C-choline and 18F-FDG PET/CT detected HCC with high sensitivity. This approach appears to be of potential prognostic value and may facilitate the selection of patients for surgical resection or liver transplantation.

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Acknowledgments

We thank Irène Buvat for critical review of the manuscript.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Hôpital Antoine Béclère, University Department Hepatinov, Assistance-Publique Hôpitaux de Paris, Clamart, France

    Maria-Angéla Castilla-Lièvre

  2. IMIV - UMR 1023 Inserm/CEA/Université Paris Sud - ERL 9218 CNRS, Orsay, 91401, France

    Maria-Angéla Castilla-Lièvre, Philippe Gervais, Bertrand Kuhnast, Serge Désarnaud & Badia-Ourkia Helal

  3. Department of Surgery, Hôpital Antoine Béclère, University Department Hepatinov, Assistance-Publique Hôpitaux de Paris, Université Paris-Sud, Clamart, France

    Dominique Franco

  4. CEA, DSV, I2BM, Service Hospitalier Frédéric Joliot, Orsay, 91401, France

    Philippe Gervais, Bertrand Kuhnast, Serge Désarnaud & Badia-Ourkia Helal

  5. Clinical Research Unit of Hôpitaux universitaires Paris-Sud, Hôpital Kremlin Bicêtre, University Department Hepatinov, Assistance-Publique Hôpitaux de Paris, Kremlin Bicêtre, France

    Hélène Agostini

  6. Department of Gastroenterology, Hôpital Antoine Béclère, University Department Hepatinov, Assistance-Publique Hôpitaux de Paris, Université Paris-Sud, Clamart, France

    Lysiane Marthey

Authors
  1. Maria-Angéla Castilla-Lièvre
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  2. Dominique Franco
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  3. Philippe Gervais
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  4. Bertrand Kuhnast
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  5. Hélène Agostini
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  6. Lysiane Marthey
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  7. Serge Désarnaud
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  8. Badia-Ourkia Helal
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Corresponding author

Correspondence to Maria-Angéla Castilla-Lièvre.

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No financial support was received.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Castilla-Lièvre, MA., Franco, D., Gervais, P. et al. Diagnostic value of combining 11C-choline and 18F-FDG PET/CT in hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 43, 852–859 (2016). https://doi.org/10.1007/s00259-015-3241-0

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  • DOI: https://doi.org/10.1007/s00259-015-3241-0

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