51. A dual-tracer approach using [11C]CH and [18F]FDG in HCC clinical decision making.
- Author
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Veenstra, Emile B., Ruiter, Simeon J. S., de Haas, Robbert J., de Jong, Koert P., Erba, Paola A., Dierckx, Rudi A. J. O., and Noordzij, Walter
- Subjects
DECISION making ,POSITRON emission tomography ,PATIENT decision making ,TUMOR markers ,COMPUTED tomography ,BIOMARKERS - Abstract
Background: Early detection of recurrent or progressive HCC remains the strongest prognostic factor for survival. Dual tracer PET/CT imaging with [
11 C]CH and [18 F]FDG can further increase detection rates as both tracers entail different metabolic pathways involved in HCC development. We investigated dual-tracer PET/CT in clinical decision making in patients suspected of recurrent or progressive HCC. All HCC patients who underwent both [11 C]CH and [18 F]FDG PET/CT in our institute from February 2018 to December 2021 were included. Both tracer PET/CT were within 4 weeks of each other with at least 6-month follow-up. Patients underwent dual tracer PET/CT because of unexplained and suspicious CT/MRI or sudden rise of serum tumour markers. A detected lesion was considered critical when the finding had prognostic consequences leading to treatment changes. Results: Nineteen patients who underwent [11 C]CH and [18 F]FDG PET/CT were included of which all but six patients were previously treated for HCC. Dual-tracer critical finding detection rate was 95%, with [18 F]FDG 68%, and [11 C]CH 84%. Intrahepatic HCC recurrence finding rate was 65% for both tracers. [18 F]FDG found more ablation site recurrences (4/5) compared to [11 C]CH (2/5). Only [11 C]CH found two needle tract metastases. Both tracers found 75% of the positive lymph nodes. Two new primary tumours were found, one by [18 F]FDG and both by [11 C]CH. Conclusions: Our study favours a dual-tracer approach in HCC staging in high-risk patients or when conventional imaging is non-conclusive. [ABSTRACT FROM AUTHOR]- Published
- 2023
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