Detection of Hepatocellular Carcinoma Using 11C-Choline PET: Comparison with 18F-FDG PET

The purpose of this study was to retrospectively investigate the feasibility of 11 C-choline PET, compared with 18 F-FDG PET, for the detection of hepatocellular carcinoma (HCC). Methods: A total of 16 HCClesions in 12 patients were examined with both 11 Ccholine PET and 18F-FDG PET. Tumor lesions were identified as areas of focally increased uptake, exceeding that of surrounding noncancerous liver tissue. For semiquantitative analysis, the tumor-to-liver (T/L) ratio was calculated by dividing the maximal standardized uptake value (SUV) in HCC lesions by the mean SUV in noncancerous liver tissue. Results: 11 C-choline PET showed a slightly higher detection rate than did 18 F-FDG PET for detection of HCC (63% vs. 50%, respectively), although this difference was not statistically significant. 11 C-choline PET had a better detection rate for moderately differentiated HCC lesions butnotforthosepoorlydifferentiated(75%vs.25%,respectively). In contrast, 18F-FDG PET exhibited the opposite behavior, with corresponding detection rates of 42% and 75%, respectively. The mean 11C-choline SUV and T/L ratio in moderately differentiated HCC lesions were higher than those in poorly differentiated HCC lesions. In contrast, the mean 18F-FDG SUV and T/L ratio inpoorly differentiated HCCwerehigher than those in moderately differentiated HCC. These differences, however, were also not statisticallysignificant.Conclusion: 11 C-choline PET hada better detection rate for moderately differentiated HCC lesions but not for poorly differentiated HCC lesions, whereas 18 F-FDG PET producedtheoppositeresult. 11 C-cholineisapotentialtracertocomplement 18F-FDG in detection of HCC lesions.