To evaluate the role of 11C-choline, 18F-FDG and double tracer PET/CT in comparison with standard imaging techniques used in HCC evaluation.
30 pts (27M, 3F, average age 56.6y ± 4.2), affected by cirrhosis-related HCC and just inserted into OLT list, were consecutively enrolled and subjected to double tracer PET/CT on the same day, during a period of ten months, from February to November 2012. CT and/or MRI positivity was considered as the standard of reference.
1) CT: 20/30 pts were submitted to CT. It was positive in all of the patients and diagnosed 1 up to 6 lesions per patient; the lesions were on average 24.9 mm in diameter (ranging from 10 to 130). 2)MRI: 26/30 pts were submitted to MRI. It diagnosed 1 up to 3 lesions per patient; lesions were 14.8 mm in diameter (ranging from 7 to 40 mm). 3) 11C-choline PET/CT: 11C-choline PET/CT was positive in 7/30 patients. Average SUVmax of lesions was 10±3.5 (ranging from 6.1 to 14.8). 4) 18F-FDG PET/CT: it was positive in 5/30 pts. Average SUVmax was 10.7 (ranging from 2.8 to 29.4) 5). Comparison between different techniques: when positive, 11C-choline perfectly overlapped with MRI. 11C-choline and CT were both positive in 6 patients. When positive, 18F-FDG perfectly overlapped with CT and/or MR. 18F-FDG and 11C-choline were both negative in 20/30 cases. CT and/or MR, when performed, were always positive in these pts. 18F-FDG and 11C-choline were both positive in two cases and also CT and MR were positive. 18F-FDG was positive and 11C-choline was negative in three cases; these patients performed also CT (3/3) and MR (2/3) and they were positive. Finally, 18F-FDG was negative and 11C-choline was positive in 5 cases; CT, performed in 4/5, was positive and MR, performed only in 1 case, was positive, too.
We evaluated that double tracer 11C-choline /18F-FDG PET/CT can be useful in investigating HCC but should be combined with other diagnostic techniques.