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Assessment of [18F]-fluoroacetate PET/CT as a tumor-imaging modality: preclinical study in healthy volunteers and clinical evaluation in patients with liver tumor

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Abstract

Objective

Although [18F]-FDG is a useful oncologic PET tracer, FDG uptake is known to be low in a certain type of hepatocellular carcinoma (HCC). [18F]-fluoroacetate (18F-FACE) is an [18F] fluorinated acetate, which is known to be converted into fatty acids, incorporated in membrane and is expected to be a promising oncologic PET tracer. The aim of this study was to evaluate the usefulness of 18F-FACE as an oncologic PET tracer in preclinical study in healthy volunteers and in patients with liver tumors.

Methods

Twenty-four healthy volunteers (age 48.2 ± 12.9 years old; 15 male and 9 female) and ten patients with liver tumor (age 72.1 ± 7.0 years old; 6 male and 4 female) were included. We performed whole-body static PET/CT scan using 18F-FACE (n = 34) and 18F-FDG (n = 5 for volunteers, n = 8 for patients) on each day, respectively. Qualitative analysis and quantitative analysis of tumors (5 HCCs, 1 cholangiocellular carcinoma, 4 metastatic tumors from colon cancer and P-NET) were performed using SUVmax and tumor-to-normal liver ratio (TNR).

Results

In healthy volunteers, 18F-FACE was metabolically stable in vivo and its biodistribution was almost similar to blood pool, basically uniformly independent of age and gender during PET scan time (up to 3 h). Normal physiological uptake of 18F-FACE at each organ including liver (SUVmean 1.8 ± 0.2) was lower than that of blood pool (SUVmean 2.3 ± 0.3) at 1 h after injection. Chronic inflammatory uptake around femur of post-operative state of femoral osteotomy and faint uptake of benign hemangioma were observed in a case of healthy volunteer. 18F-FACE (SUVmax 2.7 ± 0.6, TNR 1.5 ± 0.4) of liver tumors was significantly lower than those of 18F-FDG uptake (6.5 ± 4.2, 2.6 ± 1.7, respectively). In qualitative analysis, 18F-FDG was positive in 4 tumors (3 HCCs, 1 CCC) and negative in the other 6 tumors, while 18F-FACE was also positive in 4 tumors which were the same tumors with positive 18F-FDG uptake.

Conclusions

Biodistribution of 18F-FACE was appropriate for oncologic imaging. Tumor 18F-FACE uptake was positive in four patients with HCC and CCC, but the uptake pattern was similar to 18F-FDG. Further evaluation was needed.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 6068507, Japan

    Kenji Takemoto, Etsuro Hatano, Kan Toriguchi, Kazutaka Tanabe, Koji Kitamura, Satoru Seo, Kojiro Taura & Shinji Uemoto

  2. Department of Radiology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Ryuichi Nishii

  3. Shiga Medical Center Research Institute, 5-4-30 Moriyama, Moriyama, Shiga, 5248524, Japan

    Shinya Kagawa, Yoshihiko Kishibe, Masaaki Takahashi, Hiroshi Yamauchi & Tatsuya Higashi

  4. Department of Gastroenterology, Shiga Medical Center, 5-4-30 Moriyama, Moriyama, Shiga, 5248524, Japan

    Kazuyoshi Matsumura

  5. Department of Surgery, Shiga Medical Center, 5-4-30 Moriyama, Moriyama, Shiga, 5248524, Japan

    Masazumi Zaima

  6. Kyoto College of Medical Science, 1-3 Imakita, Oyama-higashi, Sonobe, Nantan, Kyoto, 6220041, Japan

    Keigo Endo

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  1. Kenji Takemoto
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  2. Etsuro Hatano
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  10. Kan Toriguchi
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  16. Shinji Uemoto
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Correspondence to Tatsuya Higashi.

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Takemoto, K., Hatano, E., Nishii, R. et al. Assessment of [18F]-fluoroacetate PET/CT as a tumor-imaging modality: preclinical study in healthy volunteers and clinical evaluation in patients with liver tumor. Ann Nucl Med 28, 371–380 (2014). https://doi.org/10.1007/s12149-014-0823-z

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  • DOI: https://doi.org/10.1007/s12149-014-0823-z

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