Detection of primary hepatoma with early and routine 11C-acetate PET imaging

Abstract

Objective To investigate the application of early and routine dual-phase 11 C-acetate (AC) PET in detection of primary hepatoma.Methods Forty patients (34 males,6 females; (55.4± 13.0) years) with hepatic mass were included in the study.Each patient underwent dual-phase 11C-AC PET/CT scan.The early upper-abdomen scan was performed immediately after injection of 11C-AC,following a routine whole body scan 10-20 min after injection.The retention of 11C-AC in hepatic mass were calculated as T/N ratio,R1 for early and R2 for routine respectively,and △R as changing rate between R1 and R2.The diagnostic effectiveness of early,routine and dual-phase images was analyzed based on pathological findings.x2 test and linear correlation analysis were used for statistical analysis.Results There were 28 malignant cases (24 with HCC,2 with angiosarcoma and 2 with bile duct carcinoma)and 12 benign cases (4 with infective lesion,3 with focal nodule hyperplasia,1 with adenoma,1 with reactive hyperplasia of lymph node,1 with dysplastic nodules,1 with angioleiomyolipoma,1 with liver cirrhosis nodules).The early accumulation of 11C-AC in hepatic lesions had a positive correlation with abnormal arterial blood supply (x2 =5.62,P＜0.01).A positive correlation was also found between R1 and R2(r=0.71,P＜0.01).The AUCs of ROC curves in early,routine and dual-phase images were 0.47,0.49 and 0.68 respectively.R1,R2 and △R of HCC lesions showed negative correlation with pathological grade (r:-0.61,-0.75 and-0.67,all P＜ 0.01).Conclusions Dual-phase 11C-AC PET scan is a more effective method than routine procedure to differentiate well differentiated HCC from benign ones.11C-AC retention rate supplies useful information for final diagnosis. Key words: Liver neoplasms ; Tomography, emission-computed; Acetates