a Department of Nuclear Medicine , Santa Maria Goretti Hospital , Latina , Italy.
b Department of Biomedicine and Prevention , University Tor Vergata , Rome , Italy.
Expert Rev Med Devices. 2019 May;16(5):341-350. doi: 10.1080/17434440.2019.1608817. Epub 2019 Apr 28.
Positron Emission Tomography (PET) with F-fluorodeoxyglucose (FDG) presents some limitations for imaging of hepatocellular carcinoma (HCC), the most common primary hepatic malignancy.
The authors discuss the accuracy and limitations of FDG for HCC detection. Then, authors examine the recent advances in PET tracers other than FDG for the biological and prognostic characterization of HCC such as C-acetate, C-choline, and its F-labeled derivatives.
FDG PET can be helpful for the identification of the more aggressive and poorly differentiated HCC. C-acetate is readily incorporated into intracellular phosphatidylcholine membranes and proved useful for the in vivo biological characterization of the more differentiated and less aggressive HCC. Nevertheless, the short half-life of C- radionuclide limits the clinical application of this compound. C-choline, another surrogate biomarker of cell membrane biosynthesis, has been demonstrated effective for HCC imaging. The availability of choline derivatives labeled with F-radionuclide (i.e. F-fluoroethylcholine, F-fluorocholine) has overcome the drawbacks due to C, thus triggering the clinical applications of choline PET for HCC diagnosis and management. Further research needs to be conducted to better define the alternative or complementary role of these PET probes for the characterization of HCC, with particular regard to the dual-tracer PET-CT modality.
正电子发射断层扫描（PET）结合 F-氟脱氧葡萄糖（FDG）在诊断肝细胞癌（HCC）方面存在一些局限性，HCC 是最常见的原发性肝恶性肿瘤。
作者讨论了 FDG 用于 HCC 检测的准确性和局限性。然后，作者研究了 FDG 以外的其他 PET 示踪剂在 HCC 生物学和预后特征分析方面的最新进展，如 C-乙酸盐、C-胆碱及其 F 标记衍生物。
FDG PET 有助于识别侵袭性更强、分化程度更低的 HCC。C-乙酸盐可轻易掺入细胞内磷脂酰胆碱膜，已被证明对分化程度更高、侵袭性更低的 HCC 的体内生物学特征具有重要价值。然而，C 放射性核素半衰期较短限制了该化合物的临床应用。C-胆碱是细胞膜生物合成的另一种替代生物标志物，已被证明对 HCC 成像有效。用 F-放射性核素（即 F-氟乙基胆碱、F-氟代胆碱）标记胆碱衍生物克服了 C 的缺点，从而引发了胆碱 PET 用于 HCC 诊断和管理的临床应用。需要进一步研究以更好地确定这些 PET 探针在 HCC 特征分析中的替代或补充作用，特别是在双示踪剂 PET-CT 模式下。
