Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population
Purpose Non-invasive imaging is central to hepatocellular carcinoma (HCC) diagnosis; however, conventional modalities are limited by smaller tumors and other chronic diseases that are often present in patients with HCC, such as cirrhosis. This pilot study evaluated the feasibility of (4 S )-4-(3-[ 1...
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creator | Kavanaugh, Gina Williams, Jason Morris, Andrew Scott Nickels, Michael L. Walker, Ronald Koglin, Norman Stephens, Andrew W. Washington, M. Kay Geevarghese, Sunil K. Liu, Qi Ayers, Dan Shyr, Yu Manning, H. Charles |
description | Purpose
Non-invasive imaging is central to hepatocellular carcinoma (HCC) diagnosis; however, conventional modalities are limited by smaller tumors and other chronic diseases that are often present in patients with HCC, such as cirrhosis. This pilot study evaluated the feasibility of (4
S
)-4-(3-[
18
F]fluoropropyl)-L-glutamic acid ([
18
F]FSPG) positron emission tomography (PET)/X-ray computed tomography (CT) to image HCC. [
18
F]FSPG PET/CT was compared to standard-of-care (SOC) magnetic resonance imaging (MRI) and CT, and [
11
C]acetate PET/CT, commonly used in this setting. We report the largest cohort of HCC patients imaged to date with [
18
F]FSPG PET/CT and present the first comparison to [
11
C]acetate PET/CT and SOC imaging. This study represents the first in a US HCC population, which is distinguished by different underlying comorbidities than non-US populations.
Procedures
x
C−
transporter RNA and protein levels were evaluated in HCC and matched liver samples from The Cancer Genome Atlas (
n
= 16) and a tissue microarray (
n
= 83). Eleven HCC patients who underwent prior MRI or CT scans were imaged by [
18
F]FSPG PET/CT, with seven patients also imaged with [
11
C]acetate PET/CT.
Results
x
C−
transporter RNA and protein levels were elevated in HCC samples compared to background liver. Over 50 % of low-grade HCCs and ~70 % of high-grade tumors exceeded background liver protein expression. [
18
F]FSPG PET/CT demonstrated a detection rate of 75 %. [
18
F]FSPG PET/CT also identified an HCC devoid of typical MRI enhancement pattern. Patients scanned with [
18
F]FSPG and [
11
C]acetate PET/CT exhibited a 90 and 70 % detection rate, respectively. In dually positive tumors, [
18
F]FSPG accumulation consistently resulted in significantly greater tumor-to-liver background ratios compared with [
11
C]acetate PET/CT.
Conclusions
[
18
F]FSPG PET/CT is a promising modality for HCC imaging, and larger studies are warranted to examine [
18
F]FSPG PET/CT impact on diagnosis and management of HCC. [
18
F]FSPG PET/CT may also be useful for phenotyping HCC tumor metabolism as part of precision cancer medicine. |
doi_str_mv | 10.1007/s11307-016-1007-0 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5641676</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4237368891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-841276c9ce2b001dd83c44bae64c8c1314530d9491cdde65fab46db2330b5c5a3</originalsourceid><addsrcrecordid>eNqNkU1r3DAQhkVpaT7aH9BLEfTSi1ONvmz3UCjLbhIIZCHZUylClrUbBdnaSnYg_z4yTkJaKOQkjeaZd2b0IvQJyAkQUn5LAIyUBQFZTHFB3qBDqCQpKCH0bb4LljOS0QN0lNItIVACZe_RAS1lWVaVPEQ3m8F5N9zjsMW_oFr9Xl2tT_F6eY2HgM87vbP4zO71EIz1fvQ64oWOxvWh09_xysU04IV3vTPa4-Wd9qMeXOix67HGmyu8DvtcND19QO-22if78fE8RpvV8npxVlxcnp4vfl4URhA2FBWHPJypjaVNnrdtK2Y4b7SV3FQGGHDBSFvzGkzbWim2uuGybShjpBFGaHaMfsy6-7HpbGtsP0Tt1T66Tsd7FbRTf2d6d6N24U4JyUGWMgt8fRSI4c9o06A6l6btdW_DmBRUPJNAa3gFymRJpSCT6pd_0Nswxj7_xEQJKUnJ6kzBTJkYUop2-zw3EDVZrGbLVbZ8jkmu-fxy4eeKJ48zQGcg5VS_s_FF6_-qPgCQubVE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835660739</pqid></control><display><type>article</type><title>Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kavanaugh, Gina ; Williams, Jason ; Morris, Andrew Scott ; Nickels, Michael L. ; Walker, Ronald ; Koglin, Norman ; Stephens, Andrew W. ; Washington, M. Kay ; Geevarghese, Sunil K. ; Liu, Qi ; Ayers, Dan ; Shyr, Yu ; Manning, H. Charles</creator><creatorcontrib>Kavanaugh, Gina ; Williams, Jason ; Morris, Andrew Scott ; Nickels, Michael L. ; Walker, Ronald ; Koglin, Norman ; Stephens, Andrew W. ; Washington, M. Kay ; Geevarghese, Sunil K. ; Liu, Qi ; Ayers, Dan ; Shyr, Yu ; Manning, H. Charles</creatorcontrib><description>Purpose
Non-invasive imaging is central to hepatocellular carcinoma (HCC) diagnosis; however, conventional modalities are limited by smaller tumors and other chronic diseases that are often present in patients with HCC, such as cirrhosis. This pilot study evaluated the feasibility of (4
S
)-4-(3-[
18
F]fluoropropyl)-L-glutamic acid ([
18
F]FSPG) positron emission tomography (PET)/X-ray computed tomography (CT) to image HCC. [
18
F]FSPG PET/CT was compared to standard-of-care (SOC) magnetic resonance imaging (MRI) and CT, and [
11
C]acetate PET/CT, commonly used in this setting. We report the largest cohort of HCC patients imaged to date with [
18
F]FSPG PET/CT and present the first comparison to [
11
C]acetate PET/CT and SOC imaging. This study represents the first in a US HCC population, which is distinguished by different underlying comorbidities than non-US populations.
Procedures
x
C−
transporter RNA and protein levels were evaluated in HCC and matched liver samples from The Cancer Genome Atlas (
n
= 16) and a tissue microarray (
n
= 83). Eleven HCC patients who underwent prior MRI or CT scans were imaged by [
18
F]FSPG PET/CT, with seven patients also imaged with [
11
C]acetate PET/CT.
Results
x
C−
transporter RNA and protein levels were elevated in HCC samples compared to background liver. Over 50 % of low-grade HCCs and ~70 % of high-grade tumors exceeded background liver protein expression. [
18
F]FSPG PET/CT demonstrated a detection rate of 75 %. [
18
F]FSPG PET/CT also identified an HCC devoid of typical MRI enhancement pattern. Patients scanned with [
18
F]FSPG and [
11
C]acetate PET/CT exhibited a 90 and 70 % detection rate, respectively. In dually positive tumors, [
18
F]FSPG accumulation consistently resulted in significantly greater tumor-to-liver background ratios compared with [
11
C]acetate PET/CT.
Conclusions
[
18
F]FSPG PET/CT is a promising modality for HCC imaging, and larger studies are warranted to examine [
18
F]FSPG PET/CT impact on diagnosis and management of HCC. [
18
F]FSPG PET/CT may also be useful for phenotyping HCC tumor metabolism as part of precision cancer medicine.</description><identifier>ISSN: 1536-1632</identifier><identifier>EISSN: 1860-2002</identifier><identifier>DOI: 10.1007/s11307-016-1007-0</identifier><identifier>PMID: 27677886</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Acetates - chemistry ; Adult ; Aged ; Amino Acid Transport System y+ - genetics ; Amino Acid Transport System y+ - metabolism ; Carbon Radioisotopes ; Carcinoma, Hepatocellular - diagnostic imaging ; Carcinoma, Hepatocellular - genetics ; Carcinoma, Hepatocellular - pathology ; Female ; Glutamates - chemistry ; Glutamic Acid - chemistry ; Humans ; Imaging ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - genetics ; Liver Neoplasms - pathology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Positron-Emission Tomography - methods ; Radiology ; Radiopharmaceuticals - chemistry ; Research Article ; Sequence Analysis, RNA ; Tissue Array Analysis</subject><ispartof>Molecular imaging and biology, 2016-12, Vol.18 (6), p.924-934</ispartof><rights>World Molecular Imaging Society 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-841276c9ce2b001dd83c44bae64c8c1314530d9491cdde65fab46db2330b5c5a3</citedby><cites>FETCH-LOGICAL-c503t-841276c9ce2b001dd83c44bae64c8c1314530d9491cdde65fab46db2330b5c5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11307-016-1007-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11307-016-1007-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27677886$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kavanaugh, Gina</creatorcontrib><creatorcontrib>Williams, Jason</creatorcontrib><creatorcontrib>Morris, Andrew Scott</creatorcontrib><creatorcontrib>Nickels, Michael L.</creatorcontrib><creatorcontrib>Walker, Ronald</creatorcontrib><creatorcontrib>Koglin, Norman</creatorcontrib><creatorcontrib>Stephens, Andrew W.</creatorcontrib><creatorcontrib>Washington, M. Kay</creatorcontrib><creatorcontrib>Geevarghese, Sunil K.</creatorcontrib><creatorcontrib>Liu, Qi</creatorcontrib><creatorcontrib>Ayers, Dan</creatorcontrib><creatorcontrib>Shyr, Yu</creatorcontrib><creatorcontrib>Manning, H. Charles</creatorcontrib><title>Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population</title><title>Molecular imaging and biology</title><addtitle>Mol Imaging Biol</addtitle><addtitle>Mol Imaging Biol</addtitle><description>Purpose
Non-invasive imaging is central to hepatocellular carcinoma (HCC) diagnosis; however, conventional modalities are limited by smaller tumors and other chronic diseases that are often present in patients with HCC, such as cirrhosis. This pilot study evaluated the feasibility of (4
S
)-4-(3-[
18
F]fluoropropyl)-L-glutamic acid ([
18
F]FSPG) positron emission tomography (PET)/X-ray computed tomography (CT) to image HCC. [
18
F]FSPG PET/CT was compared to standard-of-care (SOC) magnetic resonance imaging (MRI) and CT, and [
11
C]acetate PET/CT, commonly used in this setting. We report the largest cohort of HCC patients imaged to date with [
18
F]FSPG PET/CT and present the first comparison to [
11
C]acetate PET/CT and SOC imaging. This study represents the first in a US HCC population, which is distinguished by different underlying comorbidities than non-US populations.
Procedures
x
C−
transporter RNA and protein levels were evaluated in HCC and matched liver samples from The Cancer Genome Atlas (
n
= 16) and a tissue microarray (
n
= 83). Eleven HCC patients who underwent prior MRI or CT scans were imaged by [
18
F]FSPG PET/CT, with seven patients also imaged with [
11
C]acetate PET/CT.
Results
x
C−
transporter RNA and protein levels were elevated in HCC samples compared to background liver. Over 50 % of low-grade HCCs and ~70 % of high-grade tumors exceeded background liver protein expression. [
18
F]FSPG PET/CT demonstrated a detection rate of 75 %. [
18
F]FSPG PET/CT also identified an HCC devoid of typical MRI enhancement pattern. Patients scanned with [
18
F]FSPG and [
11
C]acetate PET/CT exhibited a 90 and 70 % detection rate, respectively. In dually positive tumors, [
18
F]FSPG accumulation consistently resulted in significantly greater tumor-to-liver background ratios compared with [
11
C]acetate PET/CT.
Conclusions
[
18
F]FSPG PET/CT is a promising modality for HCC imaging, and larger studies are warranted to examine [
18
F]FSPG PET/CT impact on diagnosis and management of HCC. [
18
F]FSPG PET/CT may also be useful for phenotyping HCC tumor metabolism as part of precision cancer medicine.</description><subject>Acetates - chemistry</subject><subject>Adult</subject><subject>Aged</subject><subject>Amino Acid Transport System y+ - genetics</subject><subject>Amino Acid Transport System y+ - metabolism</subject><subject>Carbon Radioisotopes</subject><subject>Carcinoma, Hepatocellular - diagnostic imaging</subject><subject>Carcinoma, Hepatocellular - genetics</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Female</subject><subject>Glutamates - chemistry</subject><subject>Glutamic Acid - chemistry</subject><subject>Humans</subject><subject>Imaging</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Liver Neoplasms - genetics</subject><subject>Liver Neoplasms - pathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Positron-Emission Tomography - methods</subject><subject>Radiology</subject><subject>Radiopharmaceuticals - chemistry</subject><subject>Research Article</subject><subject>Sequence Analysis, RNA</subject><subject>Tissue Array Analysis</subject><issn>1536-1632</issn><issn>1860-2002</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1r3DAQhkVpaT7aH9BLEfTSi1ONvmz3UCjLbhIIZCHZUylClrUbBdnaSnYg_z4yTkJaKOQkjeaZd2b0IvQJyAkQUn5LAIyUBQFZTHFB3qBDqCQpKCH0bb4LljOS0QN0lNItIVACZe_RAS1lWVaVPEQ3m8F5N9zjsMW_oFr9Xl2tT_F6eY2HgM87vbP4zO71EIz1fvQ64oWOxvWh09_xysU04IV3vTPa4-Wd9qMeXOix67HGmyu8DvtcND19QO-22if78fE8RpvV8npxVlxcnp4vfl4URhA2FBWHPJypjaVNnrdtK2Y4b7SV3FQGGHDBSFvzGkzbWim2uuGybShjpBFGaHaMfsy6-7HpbGtsP0Tt1T66Tsd7FbRTf2d6d6N24U4JyUGWMgt8fRSI4c9o06A6l6btdW_DmBRUPJNAa3gFymRJpSCT6pd_0Nswxj7_xEQJKUnJ6kzBTJkYUop2-zw3EDVZrGbLVbZ8jkmu-fxy4eeKJ48zQGcg5VS_s_FF6_-qPgCQubVE</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Kavanaugh, Gina</creator><creator>Williams, Jason</creator><creator>Morris, Andrew Scott</creator><creator>Nickels, Michael L.</creator><creator>Walker, Ronald</creator><creator>Koglin, Norman</creator><creator>Stephens, Andrew W.</creator><creator>Washington, M. Kay</creator><creator>Geevarghese, Sunil K.</creator><creator>Liu, Qi</creator><creator>Ayers, Dan</creator><creator>Shyr, Yu</creator><creator>Manning, H. Charles</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>L6V</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161201</creationdate><title>Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population</title><author>Kavanaugh, Gina ; Williams, Jason ; Morris, Andrew Scott ; Nickels, Michael L. ; Walker, Ronald ; Koglin, Norman ; Stephens, Andrew W. ; Washington, M. Kay ; Geevarghese, Sunil K. ; Liu, Qi ; Ayers, Dan ; Shyr, Yu ; Manning, H. Charles</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-841276c9ce2b001dd83c44bae64c8c1314530d9491cdde65fab46db2330b5c5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acetates - chemistry</topic><topic>Adult</topic><topic>Aged</topic><topic>Amino Acid Transport System y+ - genetics</topic><topic>Amino Acid Transport System y+ - metabolism</topic><topic>Carbon Radioisotopes</topic><topic>Carcinoma, Hepatocellular - diagnostic imaging</topic><topic>Carcinoma, Hepatocellular - genetics</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Female</topic><topic>Glutamates - chemistry</topic><topic>Glutamic Acid - chemistry</topic><topic>Humans</topic><topic>Imaging</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Liver Neoplasms - genetics</topic><topic>Liver Neoplasms - pathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Positron-Emission Tomography - methods</topic><topic>Radiology</topic><topic>Radiopharmaceuticals - chemistry</topic><topic>Research Article</topic><topic>Sequence Analysis, RNA</topic><topic>Tissue Array Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kavanaugh, Gina</creatorcontrib><creatorcontrib>Williams, Jason</creatorcontrib><creatorcontrib>Morris, Andrew Scott</creatorcontrib><creatorcontrib>Nickels, Michael L.</creatorcontrib><creatorcontrib>Walker, Ronald</creatorcontrib><creatorcontrib>Koglin, Norman</creatorcontrib><creatorcontrib>Stephens, Andrew W.</creatorcontrib><creatorcontrib>Washington, M. Kay</creatorcontrib><creatorcontrib>Geevarghese, Sunil K.</creatorcontrib><creatorcontrib>Liu, Qi</creatorcontrib><creatorcontrib>Ayers, Dan</creatorcontrib><creatorcontrib>Shyr, Yu</creatorcontrib><creatorcontrib>Manning, H. Charles</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Engineering Collection</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Molecular imaging and biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kavanaugh, Gina</au><au>Williams, Jason</au><au>Morris, Andrew Scott</au><au>Nickels, Michael L.</au><au>Walker, Ronald</au><au>Koglin, Norman</au><au>Stephens, Andrew W.</au><au>Washington, M. Kay</au><au>Geevarghese, Sunil K.</au><au>Liu, Qi</au><au>Ayers, Dan</au><au>Shyr, Yu</au><au>Manning, H. Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population</atitle><jtitle>Molecular imaging and biology</jtitle><stitle>Mol Imaging Biol</stitle><addtitle>Mol Imaging Biol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>18</volume><issue>6</issue><spage>924</spage><epage>934</epage><pages>924-934</pages><issn>1536-1632</issn><eissn>1860-2002</eissn><abstract>Purpose
Non-invasive imaging is central to hepatocellular carcinoma (HCC) diagnosis; however, conventional modalities are limited by smaller tumors and other chronic diseases that are often present in patients with HCC, such as cirrhosis. This pilot study evaluated the feasibility of (4
S
)-4-(3-[
18
F]fluoropropyl)-L-glutamic acid ([
18
F]FSPG) positron emission tomography (PET)/X-ray computed tomography (CT) to image HCC. [
18
F]FSPG PET/CT was compared to standard-of-care (SOC) magnetic resonance imaging (MRI) and CT, and [
11
C]acetate PET/CT, commonly used in this setting. We report the largest cohort of HCC patients imaged to date with [
18
F]FSPG PET/CT and present the first comparison to [
11
C]acetate PET/CT and SOC imaging. This study represents the first in a US HCC population, which is distinguished by different underlying comorbidities than non-US populations.
Procedures
x
C−
transporter RNA and protein levels were evaluated in HCC and matched liver samples from The Cancer Genome Atlas (
n
= 16) and a tissue microarray (
n
= 83). Eleven HCC patients who underwent prior MRI or CT scans were imaged by [
18
F]FSPG PET/CT, with seven patients also imaged with [
11
C]acetate PET/CT.
Results
x
C−
transporter RNA and protein levels were elevated in HCC samples compared to background liver. Over 50 % of low-grade HCCs and ~70 % of high-grade tumors exceeded background liver protein expression. [
18
F]FSPG PET/CT demonstrated a detection rate of 75 %. [
18
F]FSPG PET/CT also identified an HCC devoid of typical MRI enhancement pattern. Patients scanned with [
18
F]FSPG and [
11
C]acetate PET/CT exhibited a 90 and 70 % detection rate, respectively. In dually positive tumors, [
18
F]FSPG accumulation consistently resulted in significantly greater tumor-to-liver background ratios compared with [
11
C]acetate PET/CT.
Conclusions
[
18
F]FSPG PET/CT is a promising modality for HCC imaging, and larger studies are warranted to examine [
18
F]FSPG PET/CT impact on diagnosis and management of HCC. [
18
F]FSPG PET/CT may also be useful for phenotyping HCC tumor metabolism as part of precision cancer medicine.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27677886</pmid><doi>10.1007/s11307-016-1007-0</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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issn | 1536-1632 1860-2002 |
language | eng |
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source | MEDLINE; SpringerLink Journals - AutoHoldings |
subjects | Acetates - chemistry Adult Aged Amino Acid Transport System y+ - genetics Amino Acid Transport System y+ - metabolism Carbon Radioisotopes Carcinoma, Hepatocellular - diagnostic imaging Carcinoma, Hepatocellular - genetics Carcinoma, Hepatocellular - pathology Female Glutamates - chemistry Glutamic Acid - chemistry Humans Imaging Liver Neoplasms - diagnostic imaging Liver Neoplasms - genetics Liver Neoplasms - pathology Male Medicine Medicine & Public Health Middle Aged Positron-Emission Tomography - methods Radiology Radiopharmaceuticals - chemistry Research Article Sequence Analysis, RNA Tissue Array Analysis |
title | Utility of [18F]FSPG PET to Image Hepatocellular Carcinoma: First Clinical Evaluation in a US Population |
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