Detection of hepatocellular carcinoma using 11C-choline PET:: Comparison with 18F-FDG PET

The purpose of this study was to retrospectively investigate the feasibility of C-11-choline PET, compared with F-18-FDG PET, for the detection of hepatocellular carcinoma HCC). Methods: A total of 16 HCC lesions in 12 patients were examined with both C-11-choline PET and F-18-FDG PET. Tumor lesions were identified as areas of focally increased uptake, exceeding that of surrounding noncancerous liver tissue. For semiquantitative analysis, the tumor-to-liver (T/L) ratio was calculated by dividing the maximal standardized uptake value (SUV) in HCC lesions by the mean SUV in noncancerous liver tissue. Results: C-11-choline PET showed a slightly higher detection rate than did F-18-FDG PET for detection of HCC (63% vs. 50%, respectively), although this difference was not statistically significant. C-11-choline PET had a better detection rate for moderately differentiated HCC lesions but not for those poorly differentiated (75% vs. 25%, respectively). In contrast, F-18-FDG PET exhibited the opposite behavior, with corresponding detection rates of 42% and 75%, respectively. The mean C-11-choline SUV and T/L ratio in moderately differentiated HCC lesions were higher than those in poorly differentiated HCC lesions. In contrast, the mean F-18-FDG SUV and T/L ratio in poorly differentiated HCC were higher than those in moderately differentiated HCC. These differences, however, were also not statistically significant. Conclusion: C-11-choline PET had a better detection rate for moderately differentiated HCC lesions but not for poorly differentiated HCC lesions, whereas F-18-FDG PET produced the opposite result. C-11-choline is a potential tracer to complement F-18-FDG in detection of HCC lesions.