Abstract
Four tumor-bearing and one control woodchucks were involved in this study. They were first imaged by PET in fed state followed by another imaging session one week later when they were fasted over-night. Some animals also had FDG-PET scan that was acquired later on the same day. After imaging studies, animals were sacrificed, and their liver excised for histology. Standardized Uptake Value (SUV) was calculated using a region of interest (ROI) placed on each tumor with focal uptake. Acetate showed uptake in each HCC lesion when the animals were either fasted or fed with no significant difference in SUV values (p=0.177); some of the tumors were histologically confirmed as well-differentiated HCC while others were confirmed as moderately- or poorly-differentiated HCC; no focal uptake was found in the control animal. For the accompanying FDG scans, the uptake was detected only in animals that were fasted although the uptake pattern was different from that with acetate. This study provided a hint that fasting or not has little impact on PET imaging of HCC with acetate. It also confirmed prior finding regarding tumor heterogeneity that led to different tracer uptake pattern in the same tumor. Human studies are needed to validate the findings from this pre-clinical investigation.
Highlights
Acetate is a precursor for the synthesis of phospholipids, which can be incorporated into cell membranes [1]. [11C]acetate has high uptake in some tumors, in those in which the lipid synthesis pathway is elevated
For two animals that were imaged with both dynamic acetate and static FDG in the fed state and one week later in the fasted state, time activity curves (TACs) for acetate were generated based on region of interest (ROI) centered on the focal uptake in the tumors and in the units of SUVmean were similar between fed and fasted states, and among animals
Shown in the figure are the images of 1) acetate uptake from a frame equivalent of a 5-min static scan starting at 25-min post-injection; 2) FDG uptakefrom a 5-min static scan starting at 55-min post-injection
Summary
Acetate is a precursor for the synthesis of phospholipids, which can be incorporated into cell membranes [1]. [11C]acetate has high uptake in some tumors, in those in which the lipid synthesis pathway is elevated. Acetate has shown its potential to be a cancer imaging tracer, e.g., for prostate and liver cancers [2,3,4,5,6,7]. 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]-FDG, or FDG) is a widely used PET tracer in the clinic for cancer detection, staging and post-treatment evaluation through imaging increased level of cellular glycolysis or decreased level by treatment commonly found in cancer. It is challenging for applying FDGPET imaging to liver cancer. PET imaging with other small molecule probes such as acetate may have the clinical utility to detect HCC or to track of its progression from small HCC to frank HCC with full features, or to assess treatment response
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