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29-05-2017 | Hepatocellular carcinoma | Article

The value of [¹¹C]-acetate PET and [¹⁸F]-FDG PET in hepatocellular carcinoma before and after treatment with transarterial chemoembolization and bevacizumab

Journal: European Journal of Nuclear Medicine and Molecular Imaging

Authors: Shuren Li, Markus Peck-Radosavljevic, Philipp Ubl, Wolfgang Wadsak, Markus Mitterhauser, Eva Rainer, Matthias Pinter, Hao Wang, Christian Nanoff, Klaus Kaczirek, Alexander Haug, Marcus Hacker

Publisher: Springer Berlin Heidelberg

Abstract

Purpose

This prospective study was to investigate the value of [¹¹C]-acetate PET and [¹⁸F]-FDG PET in the evaluation of hepatocellular carcinoma (HCC) before and after treatment with transarterial chemoembolization (TACE) and vascular endothelial growth factor (VEGF) antibody (bevacizumab).

Methods

Twenty-two patients (three women, 19 men; 62 ± 8 years) with HCC verified by histopathology were treated with TACE and bevacizumab (n = 11) or placebo (n = 11). [¹¹C]-acetate PET and [¹⁸F]-FDG PET were performed before and after TACE with bevacizumab or placebo. Comparisons between groups were performed with t-tests and Chi-squared tests, where appropriate. Overall survival (OS) was defined as the time from start of bevacizumab or placebo until the date of death/last follow-up, respectively.

Results

The patient-related sensitivity of [¹¹C]-acetate PET, [¹⁸F]-FDG PET, and combined [¹¹C]-acetate and [¹⁸F]-FDG PET was 68%, 45%, and 73%, respectively. There was a significantly higher rate of conversion from [¹¹C]-acetate positive lesions to negative lesions in patients treated with TACE and bevacizumab as compared with that in patients with TACE and placebo (p < 0.05). In patients with negative acetate PET, the mean OS in patients treated with TACE and bevacizumab was 259 ± 118 days and was markedly shorter as compared with that (668 ± 217 days) in patients treated with TACE and placebo (p < 0.05). In patients treated with TACE and placebo, there was significant difference in mean OS in patients with positive FDG PET as compared with that in patients with negative FDG PET (p < 0.05). The HCC lesions had different tracer avidities showing the heterogeneity of HCC.

Conclusions

Our study suggests that combining [¹⁸F]-FDG with [¹¹C]-acetate PET could be useful for the management of HCC patients and might also provide relevant prognostic and molecular heterogeneity information.

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