title: C-11 acetate does not enhance usefulness of F-18 FDG PET/CT in differentiating between focal nodular hyperplasia and hepatic adenoma.
abstract: OBJECTIVE
  We assessed the usefulness of F-18 fluorodeoxyglucose positron emission tomography (FDG PET) and C-11 acetate PET (AC PET) in distinguishing hepatic lesions due to consequential disease (hepatocellular adenoma and malignant lesions) from focal nodular hyperplasia (FNH) in patients at low risk of malignancy.
  
  
  METHODS
  Thirty-one patients with 43 lesions were prospectively enrolled. The diagnostic work-up included Doppler and contrast-enhanced ultrasonography, contrast-enhanced computed tomography, and/or magnetic resonance imaging. Fine needle biopsy was performed if the imaging study was inconclusive. The work-up revealed 36 FNH and 7 consequential lesions (5 hepatocellular adenoma, 1 hepatoma, and 1 metastasis). All patients underwent FDG and AC PET. FDG PET with target/background ratio (T/Br) greater than 1.2 and AC PET with T/Br of less than 1.2 were considered positive test for consequential disease.
  
  
  RESULTS
  On FDG PET, we had 6 true-positive out of 7 lesions due to consequential diseases, with a sensitivity of 85.7%, and 33 true-negative out of 36 lesions with FNH, with a specificity of 91.7%. Using AC PET, there were 2 true-positive lesions out of 7 caused by neoplasms, with a sensitivity of 28.6%, and 34 true-negative lesions out of 36 FNH, with a specificity of 94.4%.
  
  
  CONCLUSIONS
  When the goal is differentiating FNH from liver neoplasms, AC PET offered no additional diagnostic advantage over what is achieved with FDG PET.
authors.affiliation: Dipartimento di Malattie Apparato Digerente e Medicina Interna, Alma Mater Studiorum, Università di Bologna, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Magini
authors.forename: Mohsen
authors.initials: M
authors.lastname: Farsad
authors.forename: Marta
authors.initials: M
authors.lastname: Frigerio
authors.forename: Carla
authors.initials: C
authors.lastname: Serra
authors.forename: Antonio
authors.initials: A
authors.lastname: Colecchia
authors.forename: Elio
authors.initials: E
authors.lastname: Jovine
authors.forename: Marco
authors.initials: M
authors.lastname: Vivarelli
authors.forename: Valentina
authors.initials: V
authors.lastname: Feletti
authors.forename: Rita
authors.initials: R
authors.lastname: Golfieri
authors.forename: Corrado
authors.initials: C
authors.lastname: Patti
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
authors.forename: Roberto
authors.initials: R
authors.lastname: Franchi
authors.forename: Filippo
authors.initials: F
authors.lastname: Lodi
authors.forename: Stefano
authors.initials: S
authors.lastname: Boschi
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Franco
authors.initials: F
authors.lastname: Trevisani
mesh_terms: D000085:Acetates; D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon; D002247:Carbon Isotopes; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000085:Acetates; D002247:Carbon Isotopes; C438206:carbon-11 acetate; D019788:Fluorodeoxyglucose F18; D002244:Carbon