The detection rate of hepatocellular carcinoma in FDG (fluorodeoxy glucose)-PET is 50 to 70%, and it is inferior to that in ultrasonic testing and computed tomograph. Since dephosphorization enzymatic activity is high in hepatocellular carcinoma, especially of highly-differentiated type, the FDG is pumped out of the cells. Studies seem to peg sensitivity of FDG PET for detection of HCC at the unacceptable 50%, though it is higher for less differentiated cancers. This is lower than CT, MRI and even ultrasound11C-acetate PET is being studied for this cancer for this reason.
BASL Guideline says: “The usefulness of positron emission tomography (PET scan) is not established in HCC.”
Chi-Lai Ho, Simon C.H. Yu, and David W.C. Yeung11C-Acetate PET Imaging in Hepatocellular Carcinoma and Other Liver Masses J Nucl Med 44: 213-221.
J.-W. Park, J. H. Kim, S. K. Kim, K. W. Kang, K. W. Park, J.-I. Choi, W. J. Lee, C.-M. Kim, and B. H. Nam
A Prospective Evaluation of 18F-FDG and 11C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma
J. Nucl. Med., December 1, 2008; 49(12): 1912 – 1921.
Y-x He and Q-y Guo
Clinical applications and advances of positron emission tomography with fluorine-18-fluorodeoxyglucose (18F-FDG) in the diagnosis of liver neoplasms
Postgrad. Med. J., May 1, 2008; 84(991): 246 – 251.