Published online Aug 28, 2019. doi: 10.3748/wjg.v25.i32.4682
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.
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.