title: Assessment of [(18)F]-fluoroacetate PET/CT as a tumor-imaging modality: preclinical study in healthy volunteers and clinical evaluation in patients with liver tumor.
abstract: OBJECTIVE
  Although [(18)F]-FDG is a useful oncologic PET tracer, FDG uptake is known to be low in a certain type of hepatocellular carcinoma (HCC). [(18)F]-fluoroacetate ((18)F-FACE) is an [(18)F] fluorinated acetate, which is known to be converted into fatty acids, incorporated in membrane and is expected to be a promising oncologic PET tracer. The aim of this study was to evaluate the usefulness of (18)F-FACE as an oncologic PET tracer in preclinical study in healthy volunteers and in patients with liver tumors.
  
  
  METHODS
  Twenty-four healthy volunteers (age 48.2 ± 12.9 years old; 15 male and 9 female) and ten patients with liver tumor (age 72.1 ± 7.0 years old; 6 male and 4 female) were included. We performed whole-body static PET/CT scan using (18)F-FACE (n = 34) and (18)F-FDG (n = 5 for volunteers, n = 8 for patients) on each day, respectively. Qualitative analysis and quantitative analysis of tumors (5 HCCs, 1 cholangiocellular carcinoma, 4 metastatic tumors from colon cancer and P-NET) were performed using SUVmax and tumor-to-normal liver ratio (TNR).
  
  
  RESULTS
  In healthy volunteers, (18)F-FACE was metabolically stable in vivo and its biodistribution was almost similar to blood pool, basically uniformly independent of age and gender during PET scan time (up to 3 h). Normal physiological uptake of (18)F-FACE at each organ including liver (SUVmean 1.8 ± 0.2) was lower than that of blood pool (SUVmean 2.3 ± 0.3) at 1 h after injection. Chronic inflammatory uptake around femur of post-operative state of femoral osteotomy and faint uptake of benign hemangioma were observed in a case of healthy volunteer. (18)F-FACE (SUVmax 2.7 ± 0.6, TNR 1.5 ± 0.4) of liver tumors was significantly lower than those of (18)F-FDG uptake (6.5 ± 4.2, 2.6 ± 1.7, respectively). In qualitative analysis, (18)F-FDG was positive in 4 tumors (3 HCCs, 1 CCC) and negative in the other 6 tumors, while (18)F-FACE was also positive in 4 tumors which were the same tumors with positive (18)F-FDG uptake.
  
  
  CONCLUSIONS
  Biodistribution of (18)F-FACE was appropriate for oncologic imaging. Tumor (18)F-FACE uptake was positive in four patients with HCC and CCC, but the uptake pattern was similar to (18)F-FDG. Further evaluation was needed.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 6068507, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takemoto
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishii
authors.forename: Shinya
authors.initials: S
authors.lastname: Kagawa
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kishibe
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Matsumura
authors.forename: Masazumi
authors.initials: M
authors.lastname: Zaima
authors.forename: Kan
authors.initials: K
authors.lastname: Toriguchi
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Tanabe
authors.forename: Koji
authors.initials: K
authors.lastname: Kitamura
authors.forename: Satoru
authors.initials: S
authors.lastname: Seo
authors.forename: Kojiro
authors.initials: K
authors.lastname: Taura
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D005463:Fluoroacetates; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D005463:Fluoroacetates; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C014815:fluoroacetic acid