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-fetoprotein level to detect hepatocellular carcinoma and differentiate from other benign liver diseases in hepatitis B virus carriers.