A Prospective Evaluation of 18F-FDG and 11C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma

Because 18F-FDG PET has insufficient sensitivity for the detec-tion of hepatocellular carcinoma (HCC), 11C-acetate PET has been proposed as another technique for this use. We prospec-tively evaluated the value of PET/CT using these 2 tracers for the detection of primary and metastatic HCC. Methods: One hundred twelve patients (99 with HCC, 13 with cholangiocellular carcinoma) underwent biopsy and 18F-FDG and 11C-acetate PET/CT.Results:The overall sensitivities of 18F-FDG, 11C-acetate, and dual-tracer PET/CT in the detection of 110 lesions in 90 patients with primary HCC were 60.9%, 75.4%, and 82.7%, respectively. Elevated serum a-fetoprotein levels, an advanced tumor stage, portal vein tumor thrombosis, large tumors, and multiple tumors were significantly associated with positive 18F-FDG PET/CT results. Uptake of 11C-acetate was associated with large and multiple tumors. For 18F-FDG, the sensitivitie