TY - JOUR T1 - Imaging Lipid Synthesis in Hepatocellular Carcinoma with [Methyl-<sup>11</sup>C]Choline: Correlation with In Vivo Metabolic Studies JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 98 LP - 106 DO - 10.2967/jnumed.110.080366 VL - 52 IS - 1 AU - Yu Kuang AU - Nicolas Salem AU - Haibin Tian AU - Jeffrey A. Kolthammer AU - David J. Corn AU - Chunying Wu AU - Fangjing Wang AU - Yanming Wang AU - Zhenghong Lee Y1 - 2011/01/01 UR - http://jnm.snmjournals.org/content/52/1/98.abstract N2 - PET with [methyl-11C]-choline (11C-choline) can be useful for detecting well-differentiated hepatocellular carcinoma (HCC) that is not 18F-FDG–avid. This study was designed to examine the relationship between choline metabolism and choline tracer uptake in HCC for PET with 11C-choline. Methods: Dynamic PET scans of 11C-choline were acquired using the woodchuck models of HCC. After imaging, [methyl-14C]-choline was injected, and metabolites from both HCC tissue samples and the surrounding hepatic tissues were extracted and analyzed by radio–high-performance liquid chromatography. The enzymatic activities of choline kinase and choline-phosphate cytidylyltransferase were assayed for correlation with the imaging and metabolism data. Results: PET with 11C-choline showed an HCC detection rate of 9 of 10. The tumor-to-liver ratio for the 9 detected HCCs was 1.89 ± 0.55. Hematoxylin-eosin staining confirmed that all spots with high tracer uptake were well-differentiated HCCs. Variation of radioactivity distribution within HCCs indicated a heterogeneous uptake of choline. The activities of both choline kinase and choline-phosphate cytidylyltransferase were found to be significantly higher in HCC than in the surrounding hepatic tissues. The major metabolites of 11C-choline were phosphocholine in HCC and betaine and choline in the surrounding hepatic tissues at 12 min after injection; in HCC, phosphocholine rapidly converted to phosphatidylcholine at 30 min after injection. Conclusion: HCCs display enhanced uptake of radiolabeled choline despite a moderate degree of physiologic uptake in the surrounding hepatic tissues. Initially, increased radiolabeled choline uptake in HCCs is associated with the transport and phosphorylation of choline; as time passes, the increased uptake of radiolabeled choline reflects increased phosphatidylcholine synthesis derived from radiolabeled cytidine 5′-diphosphocholine (CDP-choline) in HCCs. In contrast, the surrounding hepatic tissues exhibit extensive oxidation of radiolabeled choline via the phosphatidylethanolamine methylation pathway, a major contributor to the observed physiologic uptake. ER -