Fluorocholine (FCH) PET assessment of liver lesions: a pilot study
2006
Purpose: FDG PET has somewhat limited use for assessment of certain
liver lesions. It shows variable uptake in hepatocellular carcinoma (HCC)
although it may have a role in the assessment of cholangiocarcinoma. FCH
is a new tracer which allows assessment of cell membrane turnover rather
than glycolytic metabolism as with FDG. The purpose of this study was to
assess the potential utility of FCH PET in liver lesions. Methods: An ethics approved prospective trial was performed to compare FDG PET to FCH PET in patients with liver lesions. Patients with colorectal,
lung and melanoma metastases to the liver were not included. Clinicopathological
data was obtained as was follow up on enrolled patients.
Patients were scanned on a Philips Allegro GSO PET scanner at the WA
PET/Cyclotron Service. Results: : Over a 6 month period 14 subjects (6 male, 8 female) were enrolled in the trial. Mean age 59 yrs (range 26–81). The patients underwent FCH
and FDG PET scan for evaluation and therapy monitoring of suspected or
known liver lesions (8 hepatocellular carcinoma, 2 focal nodular hyperplasia,
1 cyst adenoma, 1 multiple adenomatosis, 1 cholangiocarcinoma, 1 carcinoid
metastases). 1 patient with HCC had an FCH study but did not have an
FDG PET study. Of 7 patients with known HCC recurrence, FCH was positive
in all whereas FDG was positive in 3/6. Of 1 patient with successful
treatment of HCC both FDG and FCH were negative. The cyst adenoma
and carcinoid metastases patients were both negative for FDG and FCH.
One patient with cholangiocarcinoma was positive on FDG and negative for
FCH. The opposite occurred with the two patients with FNH and multiple
adenoma.. Conclusion: Our preliminary data reveals that FCH PET appears to have
a potential role in the assessment of HCC and appears more accurate than
FDG PET in this condition. The uptake seen in benign conditions such as
FNH and adenoma needs further review. Similarly further work is required
on other conditions such as cholangiocarcinoma.
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