Comparison of 11C-acetate positron emission tomography and 67Gallium citrate scintigraphy in patients with hepatocellular carcinoma.

Nuclear imaging may have an increasing role in the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to compare prospectively the Gallium-67 citrate (⁶⁷Ga) scintigraphy results with those obtained by positron emission tomography (PET) using ¹¹C-acetate in patients with HCC. Methods: We prospectively analysed 21 patients (mean age, 64±11 years) with histopathologically verified HCC undergoing ¹¹C-acetate PET and ⁶⁷Ga scintigraphy. ⁶⁷Ga scans were not performed in three of these 21 patients due to the exacerbation of the disease. Whole-body ¹¹C-acetate PET were performed following intravenous injection of 850 MBq of ¹¹C-acetate. For ⁶⁷Ga scintigraphy, whole-body, planar and single photon emission computed tomography imaging acquisitions were performed after intravenous application of a mean dose of 189 MBq ⁶⁷Ga. Results: ⁶⁷Ga scintigraphy found abnormalities only in 10 of 18 patients (56%) and detected 22 of 46 clinically involved sites (48%); it was false-positive in two patients. ¹¹C-acetate PET found abnormalities in 14 of 18 patients (78%) and detected 36 of 46 clinical lesions (78%); it was false-positive in one patients. In one patient with left supraclavicular lymph node metastases, neither the ⁶⁷Ga scintigraphy nor the conventional computed tomography have shown the lesions, which were clearly demonstrated by the ¹¹C-acetate PET. Conclusion: Our results indicate significantly higher sensitivity and specificity of ¹¹C-acetate PET than ⁶⁷Ga scan in detection of HCC lesions. This study suggests that imaging with ¹¹C-acetate PET might play a potential role in the diagnostic workup of patients with HCC. [ABSTRACT FROM AUTHOR]