Feasibility of perfusion and early-uptake 18F-FDG PET/CT in primary hepatocellular carcinoma: a dual-input dual-compartment uptake model

Abstract

PET enables a concurrent evaluation of perfusion status and metabolic activity. We aimed to evaluate the feasibility of perfusion and early-uptake 18F-FDG PET/CT in hepatocellular carcinoma (HCC) using a dual-input dual-compartment uptake model. Data from 5 min dynamic PET/CT and conventional PET/CT scans were retrospectively collected from 17 pathologically diagnosed HCCs. Parameters such as hepatic arterial blood flow (Fa), portal vein blood flow (Fv), total blood flow (F), hepatic arterial perfusion index (HPI), portal vein perfusion index (PPI), blood volume (BV), extracellular mean transit time (MTT) and intracellular uptake rate (Ki) were calculated. Fa, HPI, MTT and Ki images were generated and used to identify HCC. Compared with the surrounding liver tissue, HCCs showed significant increases in Fa, HPI, Ki and the maximum standard uptake value (SUVmax) (all P\u2009<\u20090.001) and significant reductions in Fv (P\u2009<\u20090.05) and PPI (P\u2009<\u20090.001). F, BV and MTT (all P\u2009>\u20090.05) did not differ significantly between HCCs and the surrounding liver tissue. Perfusion and early-uptake PET/CT increased the positivity rate of HCCs from 52.9% with conventional PET/CT alone to 88.2% with the combined method (P\u2009<\u20090.05). Perfusion and early-uptake PET/CT are feasible for diagnosing HCC and provide added functional information to enhance diagnostic performance.