Copyright ©The Author(s) 2019.
World J Gastroenterol. Aug 28, 2019; 25(32): 4682-4695
Published online Aug 28, 2019. doi: 10.3748/wjg.v25.i32.4682
Table 1 Positron emission tomography for intrahepatic or extrahepatic hepatocellular carcinoma
IsotopesHalf-lifeRadiotr-acerYearFirst authorNo. of patientsStudy designIntrahepatic
Related notable findings
18F110 min18F-FDG2019Lee et al[11]-Review0.36-0.70NANANA18F-FDG PET has demonstr-ated a higher sensitivity for detecting extrahepa-tic metastasis compared to primary HCC
2012Hossein Jadvar[29]ReviewNA0.91NANA
2012Lin et al[89]Meta-analysisNANA0.770.98
18F-FCH2014Bieze et al[21]30Prospective; single-center0.881.01.01.018F-FCH shows additional value in the assessment of intra- and extrahepa-tic diseases
11C20 min11C-ACT2009Hwang et al[27]13Prospective0.83NA0.77NA11C increases the sensitivity in the detection of HCC lesions of more than 10 mm
11C-CHOL2016Castilla-Lièvre et al[71]28Prospective; single-center0.67NANANACombining 18F-FDG with 11C-CHOL could be useful for clinicians in the manage-ment of HCC patients
Table 2 Positron emission tomography in animal experiments of hepatocellular carcinoma
IsotopesHalf-lifeRadiotracerYearFirst authorAnimal modelsRelated notable findingsLimitations
18F110 min18F-FPGLU2017Sun et al[19]Tumor-bearing mice (HCC SMCC-7721)Radiochemical purity is higher than 95% with a specific activity of 30-40 GBq/μmolUnstable in plasma, tumor, and urine
Stable in vitro
High uptake and retention in tumor
64Cu12.7 h64CuCl22011Lièvre et al[71]Athymic mice bearing extrahepatic HCC xenograftsIncreased 64Cu radioactivity is well visualizedAbundant physiological distribution in liver
Useful for detection of intracranial HCC metastasis
68Ga68 min68Ga-NGR2017Gao et al[32]Tumor-bearing mice (HCC SMCC-7721)68Ga-NGR could visualize CD13-positive tumorsThe uptake performance of 68Ga-NGR for poorly differentiated HCC needs further investigation
68Ga-NGR uptake is significantly higher than that of 18F-FDG in well-differentiated HCC xenografts
89Zr78.4 h89Zr-αGPC32014Sham et al[79]HepG2 tumor-bearing miceExcellent specificityLong half-life in the blood, leading to suboptimal imaging pharmacokinetics, poorer tumor penetration, and increased immunogenicity due to relatively large size and intact Fc regions
Even smaller tumors (<1 mm) are able to be identified
89Zr-αGPC3-F(ab′)22014Sham et al[80]HepG2 tumor-bearing miceSignificantly reduces blood circulation timePotential risk of fragment concentration in the kidneys, leading to organ dysfunction
Lower background liver uptake allows for early imaging
89Zr-DFO-1G122014Yang et al[81]HepG2 tumor-bearing miceSpecifically taken up by GPC3-positive HCC xenografts regardless of GPC3 expression levelsThis probe should be further validated using a humanized anti-GPC3 antibody
High tumor-to-liver ratio
89Zr-Df-YY146-ZW8002016Hernandez et al[82]HepG2 tumor-bearing miceExcellent CD146-affinity, specificity, and stabilityBone-displaying PET signal is not matched by NIRF
Both PET and NIRF imaging are achieved