PET Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark.
Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1723-31. doi: 10.1007/s00259-011-1831-z. Epub 2011 May 7.
The aim of the study was to evaluate the feasibility of using the hepatocyte-specific positron emission tomography (PET) tracer 2-[(18)F]fluoro-2-deoxy-D-galactose (FDGal) as a tracer for hepatocellular carcinoma (HCC).
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.
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.
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.
本研究旨在评估将肝特异性正电子发射断层扫描（PET）示踪剂 2-[(18)F]氟-2-脱氧-D-半乳糖（FDGal）用作肝细胞癌（HCC）示踪剂的可行性。
除了标准的临床检查外，39 名已知患有 HCC 或疑似患有 HCC 的患者接受了全身 FDGal PET/CT（从头骨底部到大腿中部）检查。HCC 的诊断基于国际公认的标准。与周围组织相比，FDGal PET/CT 图像分析了高（热点）或低（冷点）示踪剂积聚的区域。
有 7 名患者没有 HCC，FDGal PET/CT 检查结果均为阴性。23 名患者患有 HCC，并在治疗前纳入研究。FDGal PET/CT 正确识别了其中的 22 名患者，与对比增强 CT 相当。有趣的是，在 12 名常规影像学技术不确定且需要额外诊断检查或密切随访的患者中，FDGal PET/CT 结果具有决定性。9 名患者在 HCC 治疗后纳入研究，FDGal PET/CT 能够区分活跃肿瘤组织（热点）和代谢活性低的区域（冷点）。FDGal PET/CT 在 9 名患者中检测到了肝外疾病，其中 8 名患者为新发现。
FDGal PET/CT 作为一种用于检测肝内和肝外 HCC 的 PET 示踪剂具有很大的临床潜力。在本研究中，FDGal PET/CT 的特异性为 100%，这非常有前景，但需要在更大的前瞻性研究中得到证实。
