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The potential use of 2-[18F]fluoro-2-deoxy-D-galactose as a PET/CT tracer for detection of hepatocellular carcinoma

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Abstract

Purpose

The aim of the study was to evaluate the feasibility of using the hepatocyte-specific positron emission tomography (PET) tracer 2-[18F]fluoro-2-deoxy-D-galactose (FDGal) as a tracer for hepatocellular carcinoma (HCC).

Methods

In addition to standard clinical investigations, 39 patients with known HCC or suspected of having HCC underwent a partial-body FDGal PET/CT (from base of skull to mid-thigh). Diagnosis of HCC was based on internationally approved criteria. FDGal PET/CT images were analysed for areas with high (hot spots) or low (cold spots) tracer accumulation when compared to surrounding tissue.

Results

Seven patients did not have HCC and FDGal PET/CT was negative in each of them. Twenty-three patients had HCC and were included before treatment. FDGal PET/CT correctly identified 22 of these patients, which was comparable to contrast-enhanced CT. Interestingly, FDGal PET/CT was conclusive in 12 patients in whom conventional imaging techniques were inconclusive and required additional diagnostic investigations or close follow-up. Nine patients were included after treatment of HCC and in these patients FDGal PET/CT was able to distinguish between viable tumour tissue as hot spots and areas with low metabolic activity as cold spots. FDGal PET/CT detected extrahepatic disease in nine patients which was a novel finding in eight patients.

Conclusion

FDGal PET/CT has great clinical potential as a PET tracer for detection of extra- but also intrahepatic HCC. In the present study, the specificity of FDGal PET/CT was 100%, which is very promising but needs to be confirmed in a larger, prospective study.

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Acknowledgements

The authors are thankful to the patients included in the study and the staff at the PET Centre, the clinical teams at the Dept. of Medicine V and the Liver Tumour Board at Aarhus University Hospital. The study was supported by grants from the Danish Medical Research Council (09–061564; 09–073658), the NIH (R01-DK074419) and the Danish Cancer Society (DP08024; DP06114).

Conflicts of interest

None.

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Authors and Affiliations

  1. PET Centre, Aarhus University Hospital, 8000, Aarhus C, Denmark

    Michael Sørensen, Kim Frisch, Dirk Bender & Susanne Keiding

  2. Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Aarhus, Denmark

    Michael Sørensen & Susanne Keiding

Authors
  1. Michael Sørensen
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  2. Kim Frisch
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  3. Dirk Bender
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  4. Susanne Keiding
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Correspondence to Michael Sørensen.

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Sørensen, M., Frisch, K., Bender, D. et al. The potential use of 2-[18F]fluoro-2-deoxy-D-galactose as a PET/CT tracer for detection of hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 38, 1723–1731 (2011). https://doi.org/10.1007/s00259-011-1831-z

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  • DOI: https://doi.org/10.1007/s00259-011-1831-z

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