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

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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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References

  1. Zornig C, Broelsch CE. Impact of staging on the treatment of hepatocellular carcinoma. Endoscopy 1993;25:138–142

    Article  PubMed  CAS  Google Scholar 

  2. Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996;334:693–699

    Article  PubMed  CAS  Google Scholar 

  3. Delbeke D, Martin WH, Sandler MP, Chapman WC, Wright JK Jr, Pinson CW. Evaluation of benign vs malignant hepatic lesions with positron emission tomography. Arch Surg 1998;133:510–515, discussion 515–516

    Article  PubMed  CAS  Google Scholar 

  4. Khan MA, Combs CS, Brunt EM, Lowe VJ, Wolverson MK, Solomon H, et al. Positron emission tomography scanning in the evaluation of hepatocellular carcinoma. J Hepatol 2000;32:792–797

    Article  PubMed  CAS  Google Scholar 

  5. Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, et al. Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. J Nucl Med 1992;33:333–339

    PubMed  CAS  Google Scholar 

  6. Trojan J, Schroeder O, Raedle J, Baum RP, Herrmann G, Jacobi V, et al. Fluorine-18 FDG positron emission tomography for imaging of hepatocellular carcinoma. Am J Gastroenterol 1999;94:3314–3319

    Article  PubMed  CAS  Google Scholar 

  7. Ho CL, Yu SC, Yeung DW. 11C-acetate PET imaging in hepatocellular carcinoma and other liver masses. J Nucl Med 2003;44:213–221

    PubMed  Google Scholar 

  8. Li CW, Kuo YC, Chen CY, Kuo YT, Chiu YY, She FO, et al. Quantification of choline compounds in human hepatic tumors by proton MR spectroscopy at 3 T. Magn Reson Med 2005;53:770–776

    Article  PubMed  CAS  Google Scholar 

  9. Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology 2005;42:1208–1236

    Article  PubMed  Google Scholar 

  10. Rush C, Stern J. Gallium-67 SPECT imaging in hepatocellular carcinoma. Clin Nucl Med 1988;13:535–537

    Article  PubMed  CAS  Google Scholar 

  11. Serafini AN, Jeffers LJ, Reddy KR, Heiba S, Schiff ER. Early recognition of recurrent hepatocellular carcinoma utilizing gallium-67 citrate scintigraphy. J Nucl Med 1988;29:712–716

    PubMed  CAS  Google Scholar 

  12. Chang CS, Yang SS, Yeh HZ, Kao CH, Chen GH. Tc-99m MIBI liver imaging for hepatocellular carcinoma: correlation with P-glycoprotein-multidrug-resistance gene expression. Hepatogastroenterology 2004;51:211–214

    PubMed  Google Scholar 

  13. Shreve P, Chiao PC, Humes HD, Schwaiger M, Gross MD. Carbon-11-acetate PET imaging in renal disease. J Nucl Med 1995;36:1595–1601

    PubMed  CAS  Google Scholar 

  14. Shreve PD, Gross MD. Imaging of the pancreas and related diseases with PET carbon-11-acetate. J Nucl Med 1997;38:1305–10.

    PubMed  CAS  Google Scholar 

  15. Yoshimoto M, Waki A, Yonekura Y, Sadato N, Murata T, Omata N, et al. Characterization of acetate metabolism in tumor cells in relation to cell proliferation: acetate metabolism in tumor cells. Nucl Med Biol 2001;28:117–122

    Article  PubMed  CAS  Google Scholar 

  16. DeGrado TR, Coleman RE, Wang S, Baldwin SW, Orr MD, Robertson CN, et al. Synthesis and evaluation of 18F-labeled choline as an oncologic tracer for positron emission tomography: initial findings in prostate cancer. Cancer Res 2001;61:110–117

    PubMed  CAS  Google Scholar 

  17. Hara T. 18F-fluorocholine: a new oncologic PET tracer. J Nucl Med 2001;42:1815–1817

    PubMed  CAS  Google Scholar 

  18. Kwee SA, Coel MN, Lim J, Ko JP. Prostate cancer localization with 18fluorine fluorocholine positron emission tomography. J Urol 2005;173:252–255

    Article  PubMed  Google Scholar 

  19. Schmid DT, John H, Zweifel R, Cservenyak T, Westera G, Goerres GW, et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005;235:623–628

    PubMed  Google Scholar 

  20. Ruiz-Cabello J, Cohen JS. Phospholipid metabolites as indicators of cancer cell function. NMR Biomed 1992;5:226–233

    PubMed  CAS  Google Scholar 

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Authors and 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

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