title: The potential use of 2-[¹⁸F]fluoro-2-deoxy-D-galactose as a PET/CT tracer for detection of hepatocellular carcinoma.
abstract: OBJECTIVE
  The aim of the study was to evaluate the feasibility of using the hepatocyte-specific positron emission tomography (PET) tracer 2-[(18)F]fluoro-2-deoxy-D-galactose (FDGal) as a tracer for hepatocellular carcinoma (HCC).
  
  
  METHODS
  In addition to standard clinical investigations, 39 patients with known HCC or suspected of having HCC underwent a partial-body FDGal PET/CT (from base of skull to mid-thigh). Diagnosis of HCC was based on internationally approved criteria. FDGal PET/CT images were analysed for areas with high (hot spots) or low (cold spots) tracer accumulation when compared to surrounding tissue.
  
  
  RESULTS
  Seven patients did not have HCC and FDGal PET/CT was negative in each of them. Twenty-three patients had HCC and were included before treatment. FDGal PET/CT correctly identified 22 of these patients, which was comparable to contrast-enhanced CT. Interestingly, FDGal PET/CT was conclusive in 12 patients in whom conventional imaging techniques were inconclusive and required additional diagnostic investigations or close follow-up. Nine patients were included after treatment of HCC and in these patients FDGal PET/CT was able to distinguish between viable tumour tissue as hot spots and areas with low metabolic activity as cold spots. FDGal PET/CT detected extrahepatic disease in nine patients which was a novel finding in eight patients.
  
  
  CONCLUSIONS
  FDGal PET/CT has great clinical potential as a PET tracer for detection of extra- but also intrahepatic HCC. In the present study, the specificity of FDGal PET/CT was 100%, which is very promising but needs to be confirmed in a larger, prospective study.
authors.affiliation: PET Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark. michael@pet.auh.dk
authors.forename: Michael
authors.initials: M
authors.lastname: Sørensen
authors.forename: Kim
authors.initials: K
authors.lastname: Frisch
authors.forename: Dirk
authors.initials: D
authors.lastname: Bender
authors.forename: Susanne
authors.initials: S
authors.lastname: Keiding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000378:metabolism; D005240:Feasibility Studies; D005260:Female; D005643:Fucose / Q000031:analogs & derivatives*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011849:Radioactive Tracers; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D011849:Radioactive Tracers; D005643:Fucose; C049289:2-deoxy-2-fluorogalactose