Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2019; 25(32): 4682-4695
Published online Aug 28, 2019. doi: 10.3748/wjg.v25.i32.4682
Positron-emission tomography for hepatocellular carcinoma: Current status and future prospects
Ren-Cai Lu, Bo She, Wen-Tao Gao, Yun-Hai Ji, Dong-Dong Xu, Quan-Shi Wang, Shao-Bo Wang
Ren-Cai Lu, Bo She, Wen-Tao Gao, Yun-Hai Ji, Dong-Dong Xu, Shao-Bo Wang, PET-CT Center, the First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
Quan-Shi Wang, Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Shao-Bo Wang, Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650093, Yunnan Province, China
Supported by the National Natural Science Foundation of China, No. 81760306; and the Basic Research on Application of Joint Special Funding of Science and Technology Department of Yunnan Province-Kunming Medical University, No. 2018FE001(-291).
Author contributions: Lu RC wrote the manuscript; She B, Gao WT, Ji YH, Xu DD, Wang QS, and Wang SB helped to search the literature; Wang SB and Wang QS critically revised the manuscript and approved the final version of the article to be published.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Shao-Bo Wang, MD, PhD, Associate Professor, PET-CT Center, the First People’s Hospital of Yunnan Province, 157 Jinbi Road, Kunming 650032, Yunnan Province, China.
Telephone: +86-871-63614503 Fax: +86-871-63614503
Received: April 12, 2019
Peer-review started: April 12, 2019
First decision: May 16, 2019
Revised: June 30, 2019
Accepted: July 19, 2019
Article in press: July 19, 2019
Published online: August 28, 2019

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality worldwide. Various imaging modalities provide important information about HCC for its clinical management. Since positron-emission tomography (PET) or PET-computed tomography was introduced to the oncologic setting, it has played crucial roles in detecting, distinguishing, accurately staging, and evaluating local, residual, and recurrent HCC. PET imaging visualizes tissue metabolic information that is closely associated with treatment. Dynamic PET imaging and dual-tracer have emerged as complementary techniques that aid in various aspects of HCC diagnosis. The advent of new radiotracers and the development of immuno-PET and PET-magnetic resonance imaging have improved the ability to detect lesions and have made great progress in treatment surveillance. The current PET diagnostic capabilities for HCC and the supplementary techniques are reviewed herein.

Keywords: Hepatocellular carcinoma, Positron-emission tomography, Radiotracer, Immuno-positron emission tomography

Core tip: Positron-emission tomography (PET) is an effective and noninvasive modality for visualizing hepatocellular carcinoma (HCC). This paper reviews the clinical utility of PET for HCC, including the detection of intrahepatic or extrahepatic lesions, differential diagnosis, prediction of differentiation and prognosis, and evaluation of therapeutic response. Complementary technologies, such as dynamic blood flow and dual-phase and dual-tracer PET imaging, are also mentioned. Novel radiotracers and immuno-PET have shown great potential for PET imaging and have become the focus of current research, which may enhance the diagnostic capability of PET for HCC. An overview of the current PET diagnostic status of HCC is reviewed.