[ 18F]fluoroacetate positron emission tomography for hepatocellular carcinoma and metastases: An alternative tracer for [ 11c]acetate?

Abstract

[ 11C]Acetate (ACT) positron emission tomography/computed tomography (PET/CT) is useful in the detection of hepatocellular carcinoma (HCC). This study aimed to evaluate whether [ 18F]fluoroacetate (FAC) could be an alternative analogue of [ 11C]ACT for the diagnosis of HCC. [ 18F]FAC was synthesized using the precursor t-butyl 2-(methanesulfonyloxy)ethanoate. Five volunteer patients with known HCC were recruited after consent. Whole-body [ 18F]FAC PET/CT was performed at 20 minutes and 1 hour postinjection and compared to [ 11C]ACT PET/CT at 20 minutes postinjection to assess biodistribution and tumor uptake characteristics. Qualitative and semiquantitative analyses were performed with statistical correlations on the physiologic organs of accumulation and HCC lesions for both tracers. [ 18F]FAC was obtained with 99% radiochemical purity, and the reaction yield was 16.0% with 1-hour synthesis time. The biodistribution of [ 18F]FAC on PET/CT was significantly different from that of [ 11C]ACT (p