[18F]Fluoroacetate Positron Emission Tomography for Hepatocellular Carcinoma and Metastases: An Alternative Tracer for [11C]Acetate?

• Published in: Molecular imaging Vol. 11; no. 3; pp. 229 - 239
• Main Authors: Ho, Chi-lai, Cheung, Man-ki, Chen, Sirong, Cheung, Tan To, Leung, Yim Lung, Cheng, Kam Chau, Yeung, Wing Ding
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2012
• Subjects: Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - pathology; Fluorine Radioisotopes - pharmacokinetics; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Multimodal Imaging - methods; Neoplasm Metastasis - diagnostic imaging; Positron-Emission Tomography; Radiopharmaceuticals - pharmacokinetics; Tissue Distribution; Tomography, X-Ray Computed
• DOI: 10.2310/7290.2011.00043
• ISSN: 1535-3508

[11C]Acetate (ACT) positron emission tomography/computed tomography (PET/CT) is useful in the detection of hepatocellular carcinoma (HCC). This study aimed to evaluate whether [18F]fluoroacetate (FAC) could be an alternative analogue of [11C]ACT for the diagnosis of HCC. [18F]FAC was synthesized using the precursor t-butyl 2-(methanesulfonyloxy)ethanoate. Five volunteer patients with known HCC were recruited after consent. Whole-body [18F]FAC PET/CT was performed at 20 minutes and 1 hour postinjection and compared to [11C]ACT PET/CT at 20 minutes postinjection to assess biodistribution and tumor uptake characteristics. Qualitative and semiquantitative analyses were performed with statistical correlations on the physiologic organs of accumulation and HCC lesions for both tracers. [18F]FAC was obtained with 99% radiochemical purity, and the reaction yield was 16.0% with 1-hour synthesis time. The biodistribution of [18F]FAC on PET/CT was significantly different from that of [11C]ACT (p < .05) by the lack of preferential uptake in any specific organ, particularly the pancreas, resembling the pattern of blood-pool retention although partly metabolized via the bowel. There was no significant defluorination, and none of the [11C]ACT-avid HCC lesions showed increased [18F]FAC activity. These were different from the results reported on other species. [18F]FAC may not be a potential alternative tracer for [11C]ACT in PET/CT evaluation of HCC in human subjects.