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Background  Using positron emission tomography (PET), we compared two tracers, [ 11 C]metomidate ([ 11 C]MTO) and [ 11 C]acetate ([ 11 C]ACE), for the characterization of hepatic tumors.    Methods  Thirty-three patients underwent PET with [ 11 C]MTO and [ 11 C]ACE and magnetic resonance imaging (MRI). Based on the histology of the tumor biopsy, 14 patients had hepatocellular carcinoma (HCC), 9 patients had focal nodular hyperplasia (FNH), and 10 patients had other types of hepatic tumors. Tumor uptake was evaluated by calculating the maximum and mean standardized uptake value and tumor-to-liver ratio.    Results  Altogether, 120 hepatic lesions (59 HCC, 18 FNH, 30 metastases of different primaries, 9 adenomas, and 4 regenerating nodules of liver cirrhosis) were detected by MRI. The overall tumor detection rate was slightly higher for [ 11 C]MTO (39%) than for [ 11 C]ACE (33%). [ 11 C]ACE was more sensitive for HCC detection (50% versus 43%, respectively), whereas [ 11 C]MTO was more sensitive for FNH detection (78% versus 44%, respectively). In HCC patients, the tumor grade correlated with [ 11 C]ACE, but not with [ 11 C]MTO. All of the patients with liver metastases, from various primary tumors ( n  = 10), were negative for both tracers.    Conclusions  Due to low sensitivity, [ 11 C]MTO and [ 11 C]ACE PET have only limited value in diagnosing hepatic tumors.

Characterization of hepatic tumors using [11C]metomidate through positron emission tomography: comparison with [11C]acetate