C-11 acetate does not enhance usefulness of F-18 FDG PET/CT in differentiating between focal nodular hyperplasia and hepatic adenoma.
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.
Magini
Giulia
G
Dipartimento di Malattie Apparato Digerente e Medicina Interna, Alma Mater Studiorum, Università di Bologna, Bologna, Italy.
Farsad
Mohsen
M
Frigerio
Marta
M
Serra
Carla
C
Colecchia
Antonio
A
Jovine
Elio
E
Vivarelli
Marco
M
Feletti
Valentina
V
Golfieri
Rita
R
Patti
Corrado
C
Fanti
Stefano
S
Franchi
Roberto
R
Lodi
Filippo
F
Boschi
Stefano
S
Bernardi
Mauro
M
Trevisani
Franco
F
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
D000085:Acetates; D002247:Carbon Isotopes; C438206:carbon-11 acetate; D019788:Fluorodeoxyglucose F18; D002244:Carbon