False-positive 18F fluorodeoxyglucose positron emission tomography-avid benign hepatic tumor: Previously unreported in a male patient

Steatotic Hepatitis Presenting as a Huge Hypermetabolic Liver Mass

ABSTRACT

FDG PET/CT scan is a diagnostic imaging modality for oncologic patients, but with false-positive findings in inflammatory diseases. In this interesting case, we present a 24-year-old woman with history of giant cell tumor of the bone (lumbar vertebrae) who underwent whole-body FDG PET/CT scan for treatment response evaluation. FDG PET/CT scan demonstrated a large hypermetabolic tumoral mass lesion in segment VI/VII of the right hepatic lobe. A range of malignant versus benign lesions should be considered as differential diagnoses, including metastasis, primary cholangiocarcinoma, hepatocellular carcinoma, focal nodular hyperplasia, and infection. Final diagnosis of "steatotic hepatitis" after CT-guided biopsy was established.

18F-FDG PET/CT of hepatocellular adenoma subtypes and review of literature

INTRODUCTION

This study evaluates 18F-FDG PET/CT imaging characteristics of pathologically proven hepatocellular adenoma (HCA) subtypes.

METHODS

This is a retrospective review of an institutional database (2011-2017) for subjects with a pathologic diagnosis of hepatic adenomas established within 6 months of a pre-treatment 18F-FDG PET/CT exam. An expert pathological review by a hepatopathologist was performed to confirm diagnosis and subtype HCA. A review of the 18F-FDG PET/CT exams was performed by two board-certified nuclear radiologists in consensus. Corresponding demographic and clinical data were obtained by electronic chart review.

RESULTS

Nine subjects were identified. An HCA subtype was established in seven subjects (4 HNF1A-mutated and 3 Inflammatory). The mean HCA lesion size was 2.8 cm (range 0.6-6.2, SD 2.0) with a mean SUVmax of 5.9 (range 2.1-18.9, SD 5.1). The SUV values of HNF1A-mutated HCA were significantly higher than inflammatory HCA: lesion SUVmax (5.3 ± 1.48 vs. 2.8 ± 0.59, p < 0.033), lesion-to-liver SUVmax ratio (1.4 ± 0.22 vs. 0.8 ± 0.21, p = 0.031), lesion SUVmean (3.6 ± 0.37 vs. 2.0 ± 0.46, p = 0.0086).

CONCLUSION

HNF1A-mutated HCA may have greater SUV values than inflammatory HCA on 18F-FDG PET/CT exams. However, there are contradictory data in the literature and further investigation is warranted.

Radiosynthesis of novel N-18 F-labeled 18 F-FHex-α-l-Glu and 18 F-FHex-β-Glu

N-18 F-labeled amino acids are important substitutes for new positron emission tomography (PET) imaging tracers complementing the deficiency of 18 F-fluorodeoxyglucose (18 F-FDG). In this work, two novel N-6-18 F-alkyl amino acid imaging agents, 18 F-FHex-α-l-Glu and 18 F-FHex-β-Glu, were designed and synthesized as potential probes for PET imaging of tumors. 18 F-FHex-α-l-Glu was synthesized using the precursor 6 from 18 F-F- with the yield of 16 ± 4% (n = 5, uncorrected) within about 50 minutes. The specific activity was 14.5 GBq/μmol, and the radiochemical purity was more than 95%. 18 F-FHex-β-Glu was synthesized using the precursor 12 based on 18 F-F- with the yield of 11 ± 3% (n = 3, uncorrected) in about 60 minutes. The specific activity was 9.1 GBq/μmol, and the radiochemical purity was more than 95%.