title: Diagnosis of Hepatocellular Carcinoma Using C11 Choline PET/CT: Comparison with F18 FDG, ContrastEnhanced MRI and MDCT.
abstract: OBJECTIVE
  The aim of this study was to compare C11 choline and F18 FDG PET/CT, gadoxeticenhanced 3T MRI and contrastenhanced CT for diagnosis of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Twelve chronic hepatitis B patients suspected of having HCC by abdominal ultrasonography received all diagnostic modalities performed within a oneweek timeslot. PET/CT results were analyzed visually by two independent nuclear medicine physicians and quantitatively by tumor to background ratio (T/B). Nine patients then had histopathological confirmation.
  
  
  RESULTS
  Six patients had well differentiated HCC, while two and one patient(s) were noted with moderately and poorly differentiated HCC, respectively. All were detected by both CT and MRI with an average tumor size of 5.7±3.8 cm. Five patients had positive C11 choline and F18 FDG uptake. Of the remaining four patients, three with well differentiated HCC showed negative FFDG uptake (one of which showed negative results by both tracers) and one patient with moderately differentiated HCC demonstrated no C11 choline uptake despite intense F18 FDG avidity. The overall HCC detection rates with C11 choline and F18 FDG were 78% and 67%, respectively, while the sensitivity of F18 FDG for nonwell differentiated HCC was 100%, compared with 83% of C11 choline. The average T/B of C11 choline in welldifferentiated HCC patients was higher than in moderately and poorly differentiated cases (p=0.5) and vice versa with statistical significance for T/B of F18 FDG (p = 0.02).
  
  
  CONCLUSIONS
  Our results suggested better detection rate in C11 choline for well differentiated HCC than F18 FDG PET. However, the overall detection rate of PET/CT with both tracers could not compare with contrastenhanced CT and MRI.
authors: National Cyclotron and PET Centre, Chulabhorn Hospital, Bangkok, Thailand Email : Chanisa.ja@gmail.com.
authors: Chanisa
authors: C
authors: Chotipanich
authors: Anchisa
authors: A
authors: Kunawudhi
authors: Chetsadaporn
authors: C
authors: Promteangtrong
authors: Puntira
authors: P
authors: Tungsuppawattanakit
authors: Thaniya
authors: T
authors: Sricharunrat
authors: Paramest
authors: P
authors: Wongsa
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D002794:Choline / Q000008:administration & dosage*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002794:Choline