In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET

Abstract

The present study was designed to assess glucose metabolism in hepatocellular carcinoma (HCC) with PET and [18F]fluorodeoxyglucose (FDG) and to compare the results with the measured in vitro enzymatic activity of glucose metabolism and the histologic grading of HCC.

Methods: Dynamic FDG-PET scans were obtained in 17 preoperative patients with HCC. From the serial tissue and arterial radioactivities obtained by dynamic PET, FDG kinetic rate constants (K1 to k4) were obtained. The standardized uptake value (SUV) was also determined from the images acquired 48 to 60 min after FDG administration. These PET results were compared with hexokinase and glucose-6-phosphatase (G6Pase) activities and histologic grading of HCC in surgically resected tumor materials. According to histologic grading, the tumors were divided into low-grade and high-grade HCCs.

Results: The k3 and SUV of high-grade HCCs were significantly higher than those of low-grade HCCs (p < 0.005, each). In addition, high correlations were observed between the hexokinase activities and these two parameters (r = 0.715 0.768, respectively). In some HCCs, relatively high G6Pase activities and k4 values modified tumor FDG uptake.

Conclusion: FDG PET is a valuable method for assessing glucose metabolism and histologic grading of HCC.