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First published online May 15, 2007, 10.2967/jnumed.106.036673
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Dual-Tracer PET/CT Imaging in Evaluation of Metastatic Hepatocellular Carcinoma

Chi-lai Ho, Sirong Chen, David W.C. Yeung and Thomas K.C. Cheng

Department of Nuclear Medicine and PET, Hong Kong Sanatorium and Hospital, Hong Kong, China


Figure 1
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  		FIGURE 1.  Flow chart of patient distribution shows 2 arms of analysis according to PET/CT diagnosis of HCC metastasis. Of 19 TN patients, 10 underwent curative resection and 9 were treated by radiofrequency ablation. Two FN patients initially underwent resection of their primary HCCs and, during follow-up of approximately 5–7 mo, dual-tracer PET/CT revealed metastasis, which was further treated by chemotherapy. Y = yes.

 

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  		FIGURE 2.  Mediastinal metastasis: a 49-y-old patient who had right hemihepatectomy for HCC 3 y earlier. Follow-up chest radiographs showed a right middle lobe (RML) mass. 18F-FDG and 11C-ACT PET/CT showed hypermetabolic RML lung mass and large precarinal node (arrows). Biopsy confirmed metastatic HCC pathology in both locations.

 

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  		FIGURE 3.  Multifocal bone metastases: a 62-y-old patient with previous liver resection for HCC. 18F-FDG and 11C-ACT PET/CT showed multifocal lung and bone metastases. Note that 11C-ACT revealed more bone metastasis than 18F-FDG (e.g., right humeral and thoracic lesions [small arrows]), and 11C-ACT lesions are significantly more intense. Largest left iliac lesion (large arrows) showed typical osteolytic pattern on CT bone window.

 




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