Limited value of 18F-2-deoxyglucose positron emission tomography to detect hepatocellular carcinoma in hepatitis B virus carriers.

BACKGROUND/AIMS: The differentiation of hepatocellular carcinoma from benign liver diseases in hepatitis B virus carriers by imaging studies based upon morphological aspects can be difficult.

METHODOLOGY: FDG-PET (18F-2-deoxyglucose positron emission tomographies) were performed in 48 hepatitis B virus carriers to detect hepatocellular carcinoma and differentiate other benign liver diseases. In each patient, the focal liver lesion was visible by ultrasound and an elevated serum alpha-fetoprotein level was noted. Definite diagnosis was established after ultrasound-guided liver biopsy followed by histopathological examination.

RESULTS

The histopathological examination revealed hepatocellular carcinoma in 36 patients and benign liver diseases in the remaining 12 patients. Twenty of 36 hepatocellular carcinomas were detectable by FDG-PET and none of 12 benign liver diseases were visualized by FDG-PET. The detection sensitivity of FDG-PET was not related to the echogenicity and size of hepatocellular carcinoma.

CONCLUSIONS

FDG-PET is not sensitive to but is more specific than ultrasound and serum alpha-feto-protein level to detect hepatocellular carcinoma and differentiate from other benign liver diseases in hepatitis B virus carriers.