PT  - JOURNAL ARTICLE
AU  - Kwee, Sandi
AU  - Wong, Linda
AU  - Tsai, Naoky
AU  - Okimoto, Gordon
AU  - Narayanan, Manoj
AU  - Coel, Marc
AU  - Lim, John
TI  - 18F-Fluorocholine PET/CT assessment of hepatocellular carcinoma and remnant liver function
DP  - 2011 May 01
TA  - Journal of Nuclear Medicine
PG  - 1825--1825
VI  - 52
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/52/supplement_1/1825.short
4100  - http://jnm.snmjournals.org/content/52/supplement_1/1825.full
SO  - J Nucl Med2011 May 01; 52
AB  - 1825 Objectives Fluorine-18 fluorocholine (FCH) has shown promise for PET detection of hepatocellular carcinoma (HCC) despite its high uptake in the healthy liver. However, HCC usually arises in chronic liver disease where the choice of treatment may depend on residual liver function. This study preliminarily examines the effects of liver dysfunction on hepatic FCH uptake and tumor detection in patients with prior HCC and chronic liver disease. Methods Twenty-one patients (14 with cirrhosis) underwent dynamic PET scans of the liver from 0-15 minutes post-injection of 2.22-2.96 MBq/kg of FCH followed by a static PET/CT scan of the torso. Region of interest (ROI) analysis was performed to obtain tumor and parenchymal tissue time activity curves and static standardized uptake value (SUV) measurements, as well as tumor to background ratios (TBR). Results Time activity curves from both tumor and hepatic parenchymal ROIs exhibited similar shape, with a significant plateau in uptake observed by 7 minutes post-injection. SUVmax of biopsy-confirmed HCC ranged from 6.4 to 15.2 (mean 12.3). All but one tumor (with corresponding TBR of 0.94) could be visualized on the basis of FCH uptake. No significant difference in TBR was noted between patients with and without cirrhosis (mean TBR 1.49 vs. 1.67, p=NS), although significantly lower hepatic parenchymal uptake was observed in patients with cirrhosis (ROI maximum SUV 7.6 vs. 10.2, p< 0.05; mean SUV 6.7 vs. 8.8, p< 0.05). Conclusions HCC demonstrates a significant range of FCH uptake relative to surrounding liver tissue, and diminished hepatic FCH metabolism may be seen in cirrhosis. Further research is needed to determine the relative effects of upregulated choline kinase and diminished liver function on PET/CT detection of HCC using FCH, and to investigate potential applications of FCH PET as a measure of regional hepatic reserve. Research Support This work was supported by NIH/NCI grant 3P30CA071789